Accelerated Idioventricular Rhythm

Accelerated Idioventricular Rhythm

Accelerated Idioventricular Rhythm (AIVR) is a ventricular rhythm originating from the Bundle of His, the Purkinje system or the ventricular myocytes. It can be diagnosed when three or more ventricular ectopic beats occur consecutively at a rate more than the usual idioventricular rhythm which has a rate of 20 – 40 beats per minute. The rate of AIVR is usually similar to that of the underlying sinus rhythm which it supersedes. There can be features of AV dissociation like fusion beats or capture beats. AIVR is often well tolerated and seldom needs any specific treatment. It can be overridden by accelerating the sinus rhythm with atropine. In the thrombolyting era, AIVR is often noted as a reperfusion arrhythmia. An article on the historical aspects of AIVR has been published in: Indian Pacing Electrophysiol. J. 2010;10(1):40-48

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Acute anterior wall myocardial infarction

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Baseline ECG in this case showing acute ST elevation anterior wall myocardial infarction with Q waves and ST segment elevation in anterior leads and reciprocal ST segment depression in inferior leads.