Accelerated idioventricular rhythm: history and chronology of the main discoveries

Abstract

Accelerated Idioventricular Rhythm (AIVR) is a ventricular rhythm consisting of three or more consecutive monomorphic beats, with gradual onset and gradual termination. It can rarely manifest in patients with completely normal hearts or with structural heart disease. It is usually seen during acute myocardial infarction reperfusion. This manuscript aims to review the history of the main discoveries that lead to the identification and comprehension of this fascinating arrhythmia.

Keywords: Accelerated Idioventricular Rhythm; History and Chronology; Slow ventricular tachycardia.

Figure 1

This ECG belongs to a 23 year-old male patient, Caucasian, asymptomatic. No cardiovascular history. He practiced physical activities regularly. He has been treated with azitromicine for an upper airway infection. Both panels show sinus rhythm alternating with AIVR at approximately 60 bpm. Note fusion beats (F).

Figure 2

This ECG belongs to a 67 year-old woman, presenting to the ER with an acute inferior MI (superior panel). During the administration of thrombolytics, AIVR can be seen (inferior panel) at rate of 88 bpm. AIVR alternates with sinus captures (C) and fusion beats (F).