The accelerated idioventricular rhythm occurs when depolarization rate of a normally suppressed focus increases to above that of the "higher order" focuses (the sinoatrial node and the atrioventricular node). Sinoatrial depolarization and subsequent propagation of the electrical impulse suppress the action of the lower natural pacemakers of the heart, which have slower intrinsic rates. The sinoatrial node is the first area of the heart to depolarize and to generate the action potential that leads to the depolarization of the rest of the myocardium. In the human heart, the sinoatrial node is located at the top of the right atrium. It is typically temporary and does not require treatment. AIVR is generally considered to be a benign abnormal heart rhythm. However, it is more commonly associated with reperfusion after myocardial injury.
It is also referred to as AIVR and "slow ventricular tachycardia." Though some other references limit to between 60 and 100 beats per minute. Accelerated idioventricular arrhythmias are distinguished from ventricular rhythms with rates less than 40 ( ventricular escape) and those faster than 120 ( ventricular tachycardia). Idioventricular means “relating to or affecting the cardiac ventricle alone” and refers to any ectopic ventricular arrhythmia. Monophasic R-wave with smooth upstroke and notching on the downstroke (i.e., the so-called taller left peak or "rabbit-ear".)Īccelerated idioventricular rhythm is a ventricular rhythm with a rate of between 40 and 120 beats per minute. Note the typical QRS morphology in lead V1 characteristic of ventricular ectopy from the LV. Medical condition Accelerated idioventricular rhythmĪccelerated idioventricular rhythm (AIVR) at a rate of 55/min presumably originating from the left ventricle (LV).
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