Premature atrial contractions in a bigeminy pattern (fetal echocardiography)

Case contributed by Bahman Rasuli


A 30-year-old pregnant woman was referred for fetal echocardiography because of arrhythmias seen on routine obstetric sonography.

Patient Data

Age: 30 years
Gender: Female
  • pulsed-wave Doppler recording from the left ventricular outflow tract (LVOT) in a fetus with premature atrial contractures (PACs)
  • the PACs are seen in a bigeminy pattern (occurring in every other beat)
  • the Doppler wave pattern of PACs shows only an A wave without a preceding E wave because they are fused
  • PAC referred to premature atrial contraction
  • A wave is related to atrial contractions
  • E wave is due to early filling Doppler wave from the right ventricular inflow

Case Discussion

Fetal echocardiography revealed a fetus with premature atrial contractions (PACs) in a bigeminy pattern that is usually benign. PACs in association with impaired cardiac function will predict supraventricular tachycardia and should be closely observed until PACs resolve or until delivery.

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