ECG Diagnosis: Accelerated Idioventricular Rhythm

Gildea, Thomas H; Levis, Joel T.

doi:10.7812/tpp/17-173

Cited by 8 publications

(10 citation statements)

References 6 publications

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“…AIVR traditionally has been identified as occurring after ischemia and subsequent coronary artery reperfusion, but in the emergency department, observation of AIVR is becoming less common given the increasing prevalence of percutaneous coronary intervention (PCI) over thrombolytic therapy [ 9 , 11 , 12 ]. A broad differential must always be considered when encountering AIVR.…”

Section: Discussionmentioning

confidence: 99%

“…Accelerated Idioventricular Ventricular Rhythm (AIVR) is traditionally taught as a transient rhythm after coronary artery reperfusion, but etiologies that promote ventricular automaticity must be considered as well. Other etiologies, such as electrolyte disturbances, drug toxicities as digoxin, volatile anesthetics, cardiomyopathies, and ischemia, can lead to AIVR [ 8 , 9 ]. This case highlights an instance of hyperkalemia-induced AIVR with precipitating factors of severe acute pancreatitis with anuric renal failure.…”

Section: Introductionmentioning

confidence: 99%

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Post-return of spontaneous circulation (ROSC) Accelerated Idioventricular Rhythm in the Setting of Severe Pancreatitis and Hyperkalemia

Koo¹,

Gao²

2022

Cureus

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A 73-year-old female with a history of coronary artery disease, hypertension, and diabetes presented to the emergency department in cardiac arrest. After cardiopulmonary resuscitation (CPR) and return of spontaneous circulation (ROSC), a post-ROSC electrocardiogram demonstrated Accelerated Idioventricular Rhythm (AIVR). The patient was found to have hyperkalemia due to anuric acute renal failure and antecedent severe pancreatitis. After medical management and dialysis, the patient recovered with good neurological recovery. AIVR traditionally has been seen or documented as occurring after ischemia and subsequent coronary artery reperfusion. However, etiologies that promote ventricular automaticity must be considered as well. Electrolyte disturbances, drug toxicities such as digoxin, volatile anesthetics, cardiomyopathies, and ischemia can lead to AIVR. Treatment involves considering and correcting any underlying etiology with avoidance of antiarrhythmics, which may precipitate hemodynamic instability and asystole.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Post-return of spontaneous circulation (ROSC) Accelerated Idioventricular Rhythm in the Setting of Severe Pancreatitis and Hyperkalemia

Koo¹,

Gao²

2022

Cureus

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“…2 It can also be seen with digitalis toxic effects and is rarely seen in a structurally normal heart. 3,4 It is often self-limiting and does not require treatment with antiarrhythmics, though it must be noted that AIVR and VT have been known to coexist in some clinical settings. 4,5 Because of the slower ventricular rate, fusion and capture complexes are commonly observed in this rhythm.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Chest Pain With Wide Complex Arrhythmia—No Stents Needed

2021

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“…There are three or more idioventricular beats in an accelerated rhythm (AIVR). Successive monomorphic beats with progressive beginnings and ends [10,11]. AIVR is seldom observed in people with structural heart disease or fully normal hearts, and is typically observed under the context of reperfusion after a sharp myocardial infarction (when thrombolytic treatment or invasive coronary procedures has ended).…”

Section: Causesmentioning

confidence: 99%

Critical Management of Accelerated Idioventricular Rhythm in Emergency Sitting, Review Article

BAHAIDARAH

Alawfi

alshammari³

et al. 2022

SMHJ

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The terminology "accelerated idioventricular rhythm" refers to an ectopic ventricular rhythm with three or more consecutive premature ventricular monomorphic beats with slow onset and end. That is slower than ventricular tachycardia but faster than the typical intrinsic escape rate of the ventricles, which is 30 to 40 beats per minute. Accelerated idioventricular rhythm differentiates from ventricular tachycardia in addition to having a positive outcome, a long coupling period at the beginning, a gradual drop-in ventricular rate at the conclusion, and an increase in sinus rate. After thrombolysis upon acute myocardial infarction, its presence is a sign that reperfusion was successful. Since malignant ventricular tachycardias are not commonly linked with accelerated idioventricular rhythm and the condition is typically hemodynamically well tolerated, no special therapy is typically required beyond managing the underlying heart condition. Accelerated idioventricular rhythm (AIVR) is usually benign, transitory, and untreatable. The goal of this observational study is to learn more about the clinical signs, prognosis, and therapy of frequent AIVR.

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ECG Diagnosis: Accelerated Idioventricular Rhythm

Cited by 8 publications

References 6 publications

Post-return of spontaneous circulation (ROSC) Accelerated Idioventricular Rhythm in the Setting of Severe Pancreatitis and Hyperkalemia

Post-return of spontaneous circulation (ROSC) Accelerated Idioventricular Rhythm in the Setting of Severe Pancreatitis and Hyperkalemia

An Unusual Case of Chest Pain With Wide Complex Arrhythmia—No Stents Needed

Critical Management of Accelerated Idioventricular Rhythm in Emergency Sitting, Review Article

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