Atrial Escape-Capture Bigeminy

in Dominant Atrial Rhythm With 2:1 Exit Block

 

 

Takakazu Katoh, MD,*  Shinji Kinoshita, MD,†

Ryuzaburou Yasuda, MD,‡  Yoshihiko Sasaki, MT,§

and Yoshinori Tsujimura, MD¶

 

J Electrocardiol 2003;36:349-353

 

Short title: Atrial Escape-Capture Bigeminy

 

From *Katoh Cardiovascular Clinic, Ohtsu; †Hokkaido Women's University, Ebetsu, Hokkaido; and ‡Yasuda Clinic, Moriyama; ¶Division of  Cardiology and §Clinical Laboratory Ohtsu Municipal Hospital; Japan.

 

This study was supported by a Special Grant from Hokkaido Asai Gakuen University, Ebetsu, Japan.

 

Address for correspondence: Shinji Kinoshita, MD, School of Human Services, Hokkaido Women's University, Bunkyodai 23, Ebetsu, Hokkaido 069-8511, Japan.

FAX: 81-11-387-3692

 

 

Abstract

    A 27-year-old woman with atrial bigeminy is reported in whom long PP intervals alternate with short PP intervals.  All P waves are negative in lead II and all PR intervals measure 0.12 second.  In the 12-lead electrocardiogram, however, these P waves were definitely different in configuration from each other, and were divided into two groups.  Namely, these negative P waves are divided into those of dominant atrial rhythm J1 with 2:1 exit block, and those of atrial escape J2.  Long J1-J2 intervals alternate with short J2-J1 intervals.  These electrocardiographic findings show the presence of atrial escape-capture bigeminy.  Such atrial escape-capture bigeminy in dominant atrial rhythm with 2:1 exit block has never been reported before. 

Key words: escape-capture bigeminy, dominant atrial rhythm, sick sinus syndrome.