Various structural anomalies of the left ventricular papillary muscles have been observed in recent years. Many of these
have been linked to electrocardiographic aberrations.
Recently two reports have appeared where the base of the posterior papillary muscle was identified as the source of
frequent premature ventricular complexes. In some of these patients these frequent premature ventricular complexes
have led to left ventricular dysfunction.
In this report a newly discovered structural variant of the anterior papillary muscle is described--the bifid papillary
muscle. Furthermore, it is proposed that this bifid papillary muscle is the source of frequent ventricular premature
complexes, presenting as bigeminy in a patient with normal left ventricular function.