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Ventricular Bigeminy



Notice the alternation of normal sinus beats and ventricular beats.  The sinus beats are preceded by P-waves, have narrow QRS complexes, and end with normal-appearing T-waves.  The ventricular beats are not preceded by P-waves and have wide (> 0.14 second) QRS complexes that slur into odd looking T-waves.  They are premature and are followed by compensatory pauses.  This alternation of sinus and ventricular beats gives the name ventricular bigeminy to this rhythm.