[Trigeminy of ventricular bigeminy caused by reentrant mechanism: reentry of reentry]. / Trigeminia de la bigeminia ventricular por mecanismo reentrante: reentrada de la reentrada.

The process that follows an acute myocardial infarction generates an appropriate substrate for the formation of reentry circuits, considered to be the most frequent mechanism of ventricular extrasystoles and tachyarrhythmias. We present the case of a patient with an acute myocardial infarction unusually concurring with ventricular trigeminy coupled to ventricular bigeminated extrasystoles giving rise to a trigeminy sequence over the bigeminy, which indicates the existence of two reentry circuits (reentry of reentry) that trigger ventricular flutter.

A 13-Year-Old Girl in Trigeminy During Anesthesia for Outpatient Dental Surgery: A Case Report.

A 13-year-old girl presented to a private office for dental rehabilitation under general anesthesia. The patient had a previous uneventful anesthetic 5 years prior in the same office by another dental anesthesiologist. The patient was highly anxious and would not allow monitors placed prior to induction. After an uneventful mask induction with sevoflurane, nitrous oxide, and oxygen, monitors were placed and a 22-gauge intravenous cannula inserted. The initial rhythm on the electrocardiogram was trigeminy interspersed with normal sinus rhythm. The volatile anesthetic sevoflurane was discontinued immediately, and intravenous anesthesia was started but still the patient was consistently entering trigeminy. The patient was always hemodynamically stable and never hypoxic. An in-depth discussion of the case and discussion of ventricular dysrhythmias is presented.

Cardiopulmonary Complications of Klippel-Feil Syndrome: A Case Report.

Klippel-Feil syndrome is characterized by the congenital synostosis of multiple cervical vertebrae and commonly presents with a multitude of congenital abnormalities, mainly including cardiac and respiratory defects. We present the case of a 39-year-old male with a prolonged history of cardiopulmonary symptoms whose investigations revealed restrictive lung disease, ventricular trigeminy and bigeminy, cervical vertebrae fusion, thoracic lumbar scoliosis, and mild-to-moderate pulmonary hypertension, all consistent with a diagnosis of Klippel-Feil syndrome. His management focused on preventing the progression of these findings while minimizing the effects of his extrinsic pulmonary restriction. Given the lack of guidelines in the management of such patients, this report highlights the role of early diagnosis and adequate management of such patients to reduce its progression and prevent the development of complications.

Symptomatic Ventricular Bigeminy and Trigeminy Associated With COVID-19.

Cardiac manifestations of COVID-19 are well-described in the current literature, although electrocardiogram analyses of COVID-19 patients are limited. The most common arrhythmias experienced by patients with COVID-19 include sinus tachycardia and atrial fibrillation. Ventricular bigeminy associated with COVID-19 is exceedingly rare and requires further studies to determine its incidence and clinical significance. Here, we present the case of a 57-year-old male with no prior cardiac history who was found to have COVID-19 and new-onset, symptomatic premature ventricular contraction bigeminy. This case highlights a rare potential association between COVID-19 and ventricular bigeminy/trigeminy.

Ectopic cycle length estimation from the quantified distribution patterns of ventricular bigeminy and trigeminy.

BACKGROUND: Ectopic cycle length (ECL) and the distribution patterns of ventricular bigeminy and trigeminy, expressed as their postextrasystolic intervals (PEIs) and interectopic intervals (IEIs), have been poorly pursued. OBJECTIVE: Based on modulation theory, we hypothesized that the PEIs of bigeminy and trigeminy determine their IEIs and ECL. METHODS: Ambulatory electrocardiograms of 1290 patients with ventricular premature complexes (≥3000/day) were studied. To quantify their distribution pattern on the PEI vs IEI curve (PIC), we introduced the following 2 ratios: PEI of trigeminy to PEI of bigeminy ratio (T/B-PEI) and IEI of trigeminy to IEI of bigeminy ratio (T/B-IEI). Distribution patterns were divided into 3 types by T/B-PEI: standard type (<0.90), intermediate type (between 0.90 and 1.20), and reverse type (>1.20). ECL was defined as the average of the bigeminy and trigeminy intervals in the standard type, and bigeminy intervals in the other 2 types. RESULTS: T/B-IEI disclosed significant linear relationship with T/B-PEI (P < .0001). ECLs were longest in the standard type (1905 ± 347 ms; n = 426), followed by the intermediate type (1520 ± 239 ms; n = 607) and reverse type (1317 ± 227 ms; n = 227) (P < .0001). Trigeminy PEI/ECL in the standard type (0.450 ± 0.074) was significantly shorter than that of the other 2 types (P < .0001). CONCLUSION: We confirmed that T/B-PEI determines T/B-IEI and ECL by discriminating the 3 distribution patterns. Among them, trigeminy PEI/ECL decided the 2 types of modulation by the first sinus QRS, starting at the early delay phase or the later acceleration phase.

An inappropriate shock after reprogramming tachycardia zones.

A patient with an implantable cardioverter-defibrillator (ICD) (Abbott®) had episodes of slow monomorphic ventricular tachycardia (VT) and his ICD was programmed with three tachycardia zones. During the follow-up, he received an inappropriate shock. Upon interrogation (of the device), trigeminal pattern binned as ventricular sensing (VS)-VS-ventricular fibrillation (VF) was detected. VF was assumed according to binning system. When VF is present, discrimination algorithms are not available and five consecutive sinus beats are necessary to reset binning system. Catheter ablation was performed to treat VT in order to reprogram tachycardia zones.

Ventricular trigeminy in a patient with serologically confirmed dengue haemorrhagic fever.

BACKGROUND: Cardiac arrhythmias occur during the acute stage of Dengue Haemorrhagic Fever. Dengue myocarditis is the most likely cause of the arrhythmias. CASE PRESENTATION: We report a 55-year-old patient with Dengue Haemorrhagic Fever presenting with transient ventricular trigeminy which has not been reported before. CONCLUSION: Among many other known cardiac arrhythmia seen in DHF, ventricular trigeminy is also a possibility. Clinicians should be aware of this cardiac rhythm abnormality that can occur in dengue patients.

Trigeminia de la bigeminia ventricular por mecanismo reentrante: reentrada de la reentrada / Trigeminy of ventricular bigeminy caused by reentrant mechanism: reentry of reentry

El proceso post-infarto agudo de miocardio genera el sustrato apropiado para la formación de circuitos de reentrada, los cuales son considerados como el mecanismo más frecuente de las extrasístoles y taquiarritmias ventriculares. Presentamos el trazado electrocardiográfico de un paciente con infarto agudo de miocardio en quien se observó la inusual concurrencia de una trigeminia ventricular acoplada a extrasístoles ventriculares bigeminadas, que originó una secuencia de trigeminia sobre la bigeminia, evidenciando la existencia de dos circuitos reentrantes (reentrada de la reentrada); después de una dupla de la extrasístole bigeminada se genera un aleteo ventricular.

The process that follows an acute myocardial infarction generates an appropriate substrate for the formation of reentry circuits, considered to be the most frequent mechanism of ventricular extrasystoles and tachyarrhythmias. We present the case of a patient with an acute myocardial infarction unusually concurring with ventricular trigeminy coupled to ventricular bigeminated extrasystoles giving rise to a trigeminy sequence over the bigeminy, which indicates the existence of two reentry circuits (reentry of reentry) that trigger ventricular flutter.

Clinical comparison of the treating effect of four and three therapeutic regimens on gastroduodenal ulcer / 中国现代医生

Objective To compare the effects of the quadruple, triple therapy for helicobacter pylori in peptic ulcer dis-ease to guide clinical drug use. Methods From October 2012 to May 2013, 120 patients with Hp positive peptic ulcer in our hospital were divided into two groups randomly. Patients treated with the quadruple or triple therapy for two weeks. The cure rates and the eradication rates for Hp were observed during and after treatment. Results The total cu-rative rate and eradication of the quadruple chemotherapy group were better than that of the trigeminy therapy group(P<0.05). Conclusion The application of the quadruple therapy has a good clinical therapeutical effect on gastroduo-denal ulcer, and it is worthy of being used in a wide range.

Clinical Observation on Treatment of 37 Cases of Helicobacter Pylori Infection with Self-designed Gastritis Granule / 国际中医中药杂志

Objective To observe clinical effect of treating helicobacter pylori infection with self-designed gastritis granule. Methods 37 patients of Helicobacter Pylori (Hp) infection with chronic gastritis accompanied by gastric mucosa atrophy and erosion were randomly recurited into a control group and a treatment group. The control group was treated with PPI trigeminy therapy, and the treatment group was treated with self-designed gastritis granule combined with PPI trigeminy therapy. Both groups were treated for continuous four weeks. Results The eradication rate of Hp in treatment group was significantly higher than that of the control group (P<0.05) .Conclusion The treatment of self-designed gastritis granule on chronic gastritis accompanied by gastric mucosa atrophy and erosion has effective results.