ECG Quiz 47

ECG Quiz 47

Discussion

Screenshot shows runs of wide QRS tachycardia. The inset shows cycle length of the tachycardia as 627 ms. This will correspond to a ventricular rate of nearly 96/min. Wide QRS tachycardia in this range is considered as an accelerated idioventricular rhythm (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.

Monitor screenshot showing runs of AIVR
Monitor screenshot showing runs of AIVR, isolated VPC, couplets and salvo