Escape-echo bigeminy

A narrow QRS gallop rhythm

“…An escape beat (QRS 2, 5) is retrogradely conducted to the atrium with atrial activation followed by AV conduction and ventricular capture (#3, 6). This phenomenon has been described previously as escape-echo bigeminy [ 1 ]. This echo beat could be the result of dual AV nodal pathway physiology where the retrograde conduction goes through the slow pathway.…”

An Interesting Case of Bigeminy with Presyncope

“…The 12-lead electrocardiogram shows a junctional escape-echo bigeminy with the Ashman phenomenon (Figure 1A and 1B1). 1 The first beat is not preceded by any P wave suggesting a sinus node dysfunction with a narrow escape rhythm (likely junctional ectopic having forward activation of ventricles via left and right bundle branches, and retrograde activation of the atria). Following the junctional ectopic, retrograde P waves are best seen in the inferior leads as a negative deflection on T waves.…”

“…2 The term junctional escape capture bigeminy means a bigeminal rhythm where a nodal junctional escape beat is followed by a sinus beat conducted to the ventricle either with or without aberrancy (Figure 1B2). 1 Hence, a sinus P wave resides in between two QRS complexes (a retrograde P wave instead of sinus P in case of escape-echo bigeminy).…”