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.

Monitor screenshot showing runs of AIVR
Monitor screenshot showing runs of AIVR, isolated VPC, couplets and salvo. Salvo is the occurrence of three consecutive ventricular ectopic beats. It can be considered as a short run of ventricular tachycardia if the rate is above 100/min.