Accelerated Idioventricular Rhythm

Last update 08 May 2025

Basic Info

Synonyms

AIVR, Accelerated Idioventricular Rhythm, Accelerated Idioventricular Rhythm by ECG Finding

+ [21]

Introduction

A type of automatic, not reentrant, ectopic ventricular rhythm with episodes lasting from a few seconds to a minute which usually occurs in patients with acute myocardial infarction or with DIGITALIS toxicity. The ventricular rate is faster than normal but slower than tachycardia, with an upper limit of 100 -120 beats per minute. Suppressive therapy is rarely necessary.

Clinical Trials associated with Accelerated Idioventricular Rhythm

NCT00832975

/ CompletedNot Applicable

Study of Slow Ventricular Tachycardia and Atrial Fibrillation Incidence Documented by Intracardiac Electrogram in Patients Implanted With an Implantable Cardiac Device (ICD) .

The purpose of this observational study is to collect data regarding the population of patients implanted with St. Jude Medical ICD.

Start Date01 Dec 2008

Sponsor / Collaborator

Abbott Medical Devices Trading (Shanghai) Co. Ltd.

100 Clinical Results associated with Accelerated Idioventricular Rhythm

100 Translational Medicine associated with Accelerated Idioventricular Rhythm

0 Patents (Medical) associated with Accelerated Idioventricular Rhythm

211

Literatures (Medical) associated with Accelerated Idioventricular Rhythm

02 Oct 2024·Prehospital Emergency Care

18-Month-Old with Lethargy and Accelerated Idioventricular Rhythm in Prehospital Setting: A Case Report

Article

Author: Curtis, Travis M. ; Kervin, Patrick ; Randall, Jess T. ; Mosher, Dawn M. ; Dailey, Michael W. ; Sady, Kaden M.

INTRODUCTIONWe report a case of accelerated idioventricular rhythm (AIVR) identified by Emergency Medical Services (EMS) monitoring of an infant presenting with lethargy and respiratory distress. Accelerated idioventricular rhythms are rare ventricular rhythms originating from the His-Purkinje system or ventricular myocytes, consisting of >3 monomorphic beats with gradual onset and termination.¹ An AIVR is usually well-tolerated and does not require treatment, though sustained arrythmia may induce syncope, and the rhythm has been seen in newborn infants with congenital heart diseases.¹ Monitoring ill children with ECG can identify such dysrhythmias in the prehospital setting.CASE REPORTAn 18-month-old male presented to their pediatrician with lethargy and respiratory distress, prompting activation of EMS. The patient was placed on a 4-lead ECG initially revealing monomorphic QRS complexes at a rate of 170 beats per minute (BPM). A 12-lead ECG was interpreted as sinus tachycardia by the paramedics who noted the QRS complexes were "getting taller and shorter" with a stable rapid heart rate. The clinician then noted a consistently wide tachycardia which spontaneously converted to a narrow complex tachycardia. The QRS pattern remained variable, with notation of variable R-wave height. After arrival to the emergency department, pediatric cardiology was consulted and interpreted the prehospital ECG findings as accelerated idioventricular rhythm. The patient experienced multiple occurrences of accelerated idioventricular rhythm during hospitalization without associated hypoxia or decreased perfusion.DISCUSSIONAccelerated idioventricular rhythm is relatively rare entity without underlying cardiac disease and most cases are asymptomatic or benign. In the pediatric population, AIVR is generally related to congenital heart defects, cardiac tumors, and cardiomyopathies. In the prehospital setting, continuous ECG monitoring should be a part of care by Advanced Life Support personnel in children with altered mental status, respiratory distress, unexplained syncope, or suspected arrhythmias and 12 lead ECG should be considered if there is any abnormality noted. While this patient did not experience persisting morbidity from AIVR, the potentially hazardous rhythm would not have been recognized without the astute observation, clinical management and persistent follow up of the prehospital clinicians.

01 Oct 2024·Pacing and Clinical Electrophysiology

Intracardiac echocardiography‐guided catheter ablation of highly symptomatic accelerated idioventricular rhythm originating from the right ventricular apical diverticulum

Article

Author: He, Chengde ; Li, Mengmeng ; Li, Sui ; Long, Deyong ; Yang, Sen ; Liao, Qiwei ; Li, Shaolong

AbstractVentricular diverticula are saccule‐like structures formed by the protrusion of the ventricular myocardium from the endocardial surface towards the free wall. Most diverticula are muscular structures, and patients usually have no obvious clinical symptoms. However, diverticula may contribute to arrhythmogenesis due to localized myocardial structural disturbances. Right ventricular apical diverticulum (RVAD) is very rare, and we report a case of highly symptomatic accelerated idioventricular rhythm (AIVR) originating from the RVAD that underwent intracardiac echocardiography (ICE)–guided catheter ablation with no recurrence during follow‐up.

01 Jul 2024·Annals of Noninvasive Electrocardiology

Accelerated idioventricular rhythm as a manifestation of chronic renocardiac syndrome: A case report

Article

Author: Kotzadamis, Dimitrios ; Vassilikos, Vassilios ; Gkroumtsia, Evangelia ; Papadopoulos, Christodoulos

AbstractIn this case report, we describe a patient who presented with chronic symptoms and signs of uremia and persistent accelerated idioventricular rhythm (AIVR) on electrocardiogram. Findings from blood tests, echocardiography, renal ultrasound, and renal scan were suggestive of heart failure with reduced ejection fraction and chronic kidney disease, and attendance of daily hemodialysis sessions led to the restoration of sinus rhythm. Typically, AIVR has a favorable prognosis and, if necessary, medical intervention focuses on addressing the underlying responsible causes. Accumulation of uremic toxins has the potential to trigger the formation of AIVR and clearance of small solutes through conventional hemodialysis may contribute to sinus rhythm restoration.

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