Everything you need to know about trigeminy

The medical term for an abnormal heart rhythm is arrhythmia. This condition can cause the heart to beat too slowly, too quickly, or irregularly.

The electrical activity of the heart determines how it beats. Under normal circumstances, the heartbeats will follow a regular pattern to pump blood out of the heart. The heart contracts in response to the electrical heartbeat.

Disruptions to the electrical activity or heart tissue can cause arrhythmias, however.

A premature ventricular contraction (PVC) occurs when a beat comes early and the heart contracts sooner than expected. The ventricles make up the lower part of the heart. The early contraction causes a premature or extra heartbeat that disrupts the normal rhythm.

PVCs can occur in abnormal patterns. Trigeminy occurs when every third heartbeat is a PVC.

Typically, the pattern will include two regular beats with an irregular beat before. The beat following an irregular beat is usually more forceful.

This rhythm is different from bigeminy, which is a normal heartbeat followed by a premature one (alternating normal and PVC beats).

Trigeminy is the result of abnormal or irritable ventricular electrical activity. Some structural heart issues — such as heart disease, congestive heart failure, or scarring — can also cause this irregularity.

Other possible causes include:

• low blood oxygen, such as with chronic obstructive pulmonary disease
• high blood pressure
• alcohol use
• anemia
• some medications, such as decongestants
• smoking
• increased adrenaline, such as from caffeine, exercise, or anxiety
• valvular heart disease
• thyroid abnormalities or other hormonal problems
• pregnancy
• a high level of endurance activity
• structural irregularities of the heart, such as left atrial enlargement
• sleep apnea

Trigeminy can feel as though the heart is skipping a beat. This feeling is usually a passing sensation without any further symptoms. In fact, many people experience trigeminy without knowing that they have it.

In some cases, however, a person may experience longer lasting symptoms that include:

• a fluttering sensation in the heart
• feeling the heart pounding
• increased awareness of the heart beating

In rarer cases, some people can also experience shortness of breath, chest pain, and dizziness or fatigue. If the trigeminy occurs with another condition, more symptoms can also develop.

To diagnose trigeminy, a doctor may use different tests depending on risk factors such as age, family history, and lifestyle habits.

The main test for any form of arrhythmia is an electrocardiogram (ECG). An ECG assesses the electrical activity in the heart.

The test involves having up to 12 electrodes attached to the chest while lying still on a table. These electrodes assess the electrical activity of the heart from different angles. They must have direct contact with the skin, which could involve shaving away chest or leg hair.

A doctor may order an echocardiogram, which is an ultrasound of the heart, to look for structural irregularities. These may include problems with the pumping function of the heart or scarring of the heart.

In some cases, a doctor may also require genetic testing. These tests are more common in newborns and people with a family history of certain heart conditions.

Doctors may also use MRI to create a detailed image of the heart. This is also useful for detecting scarring or other structural issues with the heart.

Trigeminy does not always cause symptoms or increase the risk of a heart condition.

Sometimes, it will resolve on its own. A doctor may also suggest making lifestyle changes — such as limiting caffeine, alcohol, tobacco, and stress — to reduce the electrical irritability of the heart tissue.

However, trigeminy may be due to an underlying cause that requires treatment, such as anxiety, anemia, or other heart issues. Also, if there is a high burden of trigeminy, it may result in dysfunction of the heart’s pumping capacity. This may also need treatment.

A doctor might prescribe medications to help with the symptoms and treat any related conditions. These medications may include antiarrhythmics, beta-blockers, or calcium channel blockers.

In more severe cases, surgery or other procedures might be necessary to treat the condition. For example, a doctor may recommend a catheter ablation.

During this type of surgery, an electrophysiologist will use radiofrequency energy to silence electrical areas of heart tissue that are causing the heart to beat with an irregular rhythm.

Leading a healthful lifestyle will reduce the risk of experiencing complications from abnormal heart rhythms.

To achieve this, a doctor might recommend:

• stopping smoking
• regularly exercising and staying active
• eating a healthful diet
• managing stress levels
• maintaining a moderate weight
• treating sleep apnea

There is no cure for trigeminy, but it can sometimes go away on its own. Many people with the condition may not even notice it or experience any symptoms.

Other people may have more frequent symptoms, or the trigeminy may impact their cardiac function and need treatment. This may involve taking medications and undergoing regular checkups with a doctor to reduce the risk of a more serious condition occurring.

Trigeminy is an abnormal heart rhythm from a PVC. The condition causes an extra beat, in a pattern occurring every third heartbeat.

Many people with trigeminy experience mild symptoms or no symptoms at all. There is often no need for treatment, as the condition can resolve on its own if a person makes certain changes to their lifestyle.

However, trigeminy can cause problems for some people. It might also indicate a more serious medical condition.

Anyone with an abnormal heart rhythm will benefit from making some healthful lifestyle changes to reduce the risk of complications.