QALY | What Ventricular Trigeminy Looks Like on Your Watch ECG

Key Takeaways

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Ventricular trigeminy is a repetitive series of two normal heartbeats and one premature ventricular contraction (PVC). Every third heartbeat is a PVC—an extra heartbeat that starts in the heart’s lower chamber (ventricle) and disturbs your regular heart rhythm.

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How to Spot Ventricular Trigeminy on Your Watch ECG

Ventricular trigeminy consists of two sinus beats followed by a premature ventricular contraction for three or more consecutive cycles.

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These are the characteristics of ventricular trigeminy:

Rhythm: Irregular
Rate: Depends on the underlying rate
P wave: Premature, varies in size and shape
QRS: Wide

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Example of Ventricular Trigeminy caught on Apple Watch ECG — Example of Ventricular Trigeminy caught on Apple Watch

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Ventricular Trigeminy recorded on Apple Watch reviewed by QALY. — Example of Apple Watch ECG with 4 PVCs in trigeminy pattern and 1 single PVC.

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Ventricular Trigeminy recorded on Samsung Watch and reviewed by QALY — Example of Samsung ECG with 6 PVCs in Trigeminy paterns and 1 single ECG.

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Common Symptoms of Ventricular Trigeminy

Ventricular bigeminy often causes few or zero symptoms. That being said, the extra beats can cause unusual sensations in the chest, such as:

Fluttering in the chest or neck
Hard beating, throbbing
Skipped or missed beats
Increased awareness of your heartbeat

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Any Cause for Concern?

PVCs are common among the general population. The estimated prevalence ranges from 1% to 4% on an electrocardiogram and 40% to 75% on a 24 or 48-hour Holter monitor. Young and healthy adults have shown a highly similar frequency rate of PVCs compared to the older segments of the general population.

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However, the extra beats can be strong enough to be painful. If they happen often enough to reduce pumping in your heart, you could feel weak, dizzy, or even faint. And if you have heart disease, trigeminy contractions can lead to unsafe heart rhythms and sudden cardiac death, but this is rare.

As always, if you show signs of potential ventricular trigeminy, contact your healthcare provider as soon as possible to rule out the presence of harmful underlying conditions.

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Still Not Sure How to Spot Ventricular Trigeminy on Your Watch ECG?

Your smartwatch can be your partner in looking after your heart. If you’re concerned about ventricular trigeminy, get your smartwatch ECGs analyzed by experts within minutes on the QALY app: iOS and Android.

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