Ventricular Trigeminy || EMS Cardiology

What is Ventricular Trigeminy? 🫀

Is it different from ventricular triplets? 🤔

Let's talk about it! 

First, we need to know what a PVC is! 

A PVC (also known as a premature ventricular contraction/complex) is a heartbeat that fires too early from the bottom chambers of the heart (the ventricles). 

Ventricular trigeminy is simply a pattern of PVCs within an underlying rhythm. It is a rhythm in which two normal impulses occur followed by a PVC. 

“1 impulse, 2 impulse and a PVC = Trigeminy” 

This abnormal rhythm can have many causes including underlying heart conditions, previous surgeries disrupting the conduction system ⚡️ of the heart 🫀, electrolyte imbalances 🧪 , sepsis, and certain medications 💊. 

It typically requires no treatment in the 911 EMS 🚑 setting aside from treating the patient’s complaint and exploring a possible underlying cause. 

🛑 If you have noted ventricular trigeminy on the cardiac monitor, it is certainly something important to report to the receiving facility. 

How does it differ from ventricular triplets? 🤔

Oftentimes it is easy to get the the two confused because they are both a pattern of PVCs within an underlying rhythm, but let’s look at the main difference. 

Ventricular triplets are three PVCs in a row, whereas, ventricular trigeminy is two normal and complete impulses followed by a PVC. 

The PVCs in ventricular triplets are back-to-back, however, every third beat is a PVC in ventricular trigeminy. 

🧨Side Note: Ventricular triplets (a salvo) can also be considered a short run of ventricular tachycardia. 

Have you ever seen ventricular trigeminy in the field and what was the situation?! ⬇️⬇️