Accelerated Idioventricular Rhythm
Let’s talk about Accelerated Idioventricular Rhythm.
Accelerated idioventricular rhythm (AIVR) is a ventricular rhythm consisting of three or more consecutive monomorphic beats, with gradual onset.
Criteria
- ≥3 monomorphic wide QRS complexes with morphology similar to PVCs.
- Ventricular rate in between 55-110 bpm.
- AV dissociation.
- Occasional fusion or capture beats can be seen.
Example 1
Example 2
The fifth complex is a capture beat (sinus P wave conducted with normal QRS) in the setting of
accelerated idioventricular rhythm (AIVR).
NOTE: AIVR is usually a benign and well-tolerated arrhythmia, but may be seen in the reperfusion phase of acute MI (reperfusion arrhythmia) and sympathetic overload. AIVR has also been associated with several drugs (eg, halothane, aconitine, desflurane, cocaine, and digitalis), electrolyte imbalances (eg, hypo- and hyperkalemia), cardiomyopathies, and during the postresuscitation period following cardiac arrest.
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