Bigeminal sandwiches galore

A long run of PVCs “sandwiched” in between the sinus beats resulting in an almost doubling of the heart rate—interpolated PVCs in bigeminy—is described. This case illustrates three interesting aspects of interpolated PVCs. Although they are not uncommon, long runs of interpolated PVCs in bigeminy are rare findings. In this case, the arrhythmia had a duration of 3 minutes. Second, it illustrates the “age-old wisdom” of partial retrograde conduction. Also, even though the arrhythmia resulted in an almost doubling of the heart rate, the patient remained asymptomatic.