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Irregular Rhythm
Michael D. Puchalski, MD; Thomas A. Miller, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Ectopic beat is extra beat arising prematurely from site other than heart's natural pacemaker
            • Extra beat can arise from anywhere (atrium or ventricle) within myocardium to produce irregular rhythm
          • Bigeminy: Every other beat is ectopic
          • Trigeminy: Every 3rd beat is ectopic
          • Couplets (and Triplets): 2 (and 3) ectopic beats in a row
          • Blocked beats: When atrial activity does not conduct to ventricles
            • When normal sinus beats are blocked, there is typically problem with atrioventricular (AV) node
            • When early atrial beats are blocked, there is typically no problem with AV node; usually variant of normal

        IMAGING

        • Echocardiographic Findings

          • Imaging Recommendations

            DIFFERENTIAL DIAGNOSIS

              PATHOLOGY

              • General Features

                CLINICAL ISSUES

                • Presentation

                  • Demographics

                    • Natural History & Prognosis

                      • Treatment

                        Selected References

                        1. Donofrio MT et al: Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation. 129(21):2183-242, 2014
                        2. Sekarski N et al: Perinatal arrhythmias. Eur J Pediatr. 173(8):983-96, 2014
                        3. Wacker-Gussmann A et al: Diagnosis and treatment of fetal arrhythmia. Am J Perinatol. 31(7):617-28, 2014
                        Related Anatomy
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                        Related Differential Diagnoses
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                        References
                        Tables

                        Tables

                        KEY FACTS

                        • Terminology

                          • Imaging

                            • Clinical Issues

                              TERMINOLOGY

                              • Definitions

                                • Ectopic beat is extra beat arising prematurely from site other than heart's natural pacemaker
                                  • Extra beat can arise from anywhere (atrium or ventricle) within myocardium to produce irregular rhythm
                                • Bigeminy: Every other beat is ectopic
                                • Trigeminy: Every 3rd beat is ectopic
                                • Couplets (and Triplets): 2 (and 3) ectopic beats in a row
                                • Blocked beats: When atrial activity does not conduct to ventricles
                                  • When normal sinus beats are blocked, there is typically problem with atrioventricular (AV) node
                                  • When early atrial beats are blocked, there is typically no problem with AV node; usually variant of normal

                              IMAGING

                              • Echocardiographic Findings

                                • Imaging Recommendations

                                  DIFFERENTIAL DIAGNOSIS

                                    PATHOLOGY

                                    • General Features

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Demographics

                                          • Natural History & Prognosis

                                            • Treatment

                                              Selected References

                                              1. Donofrio MT et al: Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation. 129(21):2183-242, 2014
                                              2. Sekarski N et al: Perinatal arrhythmias. Eur J Pediatr. 173(8):983-96, 2014
                                              3. Wacker-Gussmann A et al: Diagnosis and treatment of fetal arrhythmia. Am J Perinatol. 31(7):617-28, 2014