What is the treatment of idioventricular rhythm with rate in 20’s?
Idioventricular rhythm is a spontaneous heart rhythm originating in the ventricles (lower chambers of the heart). Usual rate of idioventricular rhythm is between 20 – 40 per minute. When the rate is in 20’s it is likely to cause symptoms due to low blood flow to the brain like giddiness and black out. More over, low rates can predispose to life threatening abnormal heart rhythms like torsades des pointes (a very fast heart rhythm which often causes the pulse to disappear as the heart cannot contract in organized fashion at such a fast rate). So it is better that the heart rate is increased in such situations. Idioventricular rhythm can be accelerated by medications which are given as intravenous (through the vein) infusions (continuous drip). A more reliable way is to introduce an electrode into the right ventricle through a vein and give electrical signals to accelerate the heart using a pacemaker. If the idioventricular rhythm is due to a permanent cause, a permanent pacemaker can be implanted under the skin and connected to the heart by an electrode.