ECG Quiz 47

ECG Quiz 47

What is the arrhythmia seen in the highlighted region of the monitor screen shot?

Discussion

Highlighted region shows a run of wide QRS rhythm. The inset shows cycle length of the rhythm as 627 ms. This will correspond to a ventricular rate of nearly 96/min. Wide QRS rhythm originating from the ventricles in this range is considered as an accelerated idioventricular rhythm or AIVR. AIVR is a common reperfusion arrhythmia which occurs after successful reperfusion of acute myocardial infarction – spontaneous, by thrombolysis or by primary angioplasty. It is usually a self-limited arrhythmia and needs no specific treatment. It can be overridden by accelerating the sinus rate with atropine.