II. Mechanism

  1. Benign transient Dysrhythmia (typically lasts minutes and resolves)
  2. Occurs after STEMI with coronary reperfusion (spontaneous or after PCI, Fibrinolysis)

III. Findings

  1. Regular wide complex rhythm (at least 3 consecutive beats)
  2. No P Waves (or P Waves with atrioventricular dissociation)
  3. Heart Rates typically 40 to 120 bpm

IV. Differential Diagnosis

  1. See Wide Complex Tachycardia
  2. Ventricular Tachycardia
    1. Typically presents with Heart Rates >120-130
  3. Other causes
    1. Digoxin Toxicity
    2. Electrolyte abnormalities (e.g. Hyperkalemia)
    3. Cardiac ischemia

V. Management

  1. Observation of suspected AIVR rhythm only
  2. Antidysrhythmic medications may degenerate AIVR to Asystole

VI. References

  1. Berberian and Brady (2024) Crit Dec Emerg Med 38(3): 15

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Ontology: Accelerated Idioventricular Rhythm (C0078888)

Definition (CHV) a kind of abnormal heart rhythm
Definition (CHV) a kind of abnormal heart rhythm
Definition (NCI_CDISC) An electrocardiographic finding of idioventricular rhythm with a rate greater than 50 beats per minute.
Definition (NCI) An electrocardiographic finding of idioventricular rhythm with a rate greater than 50 beats per minute. (CDISC)
Definition (MSH) A type of automatic, not reentrant, ectopic ventricular rhythm with episodes lasting from a few seconds to a minute which usually occurs in patients with acute myocardial infarction or with DIGITALIS toxicity. The ventricular rate is faster than normal but slower than tachycardia, with an upper limit of 100 -120 beats per minute. Suppressive therapy is rarely necessary.
Concepts Disease or Syndrome (T047)
MSH D016170
SnomedCT 61277005
English Accelerated Idioventricular Rhythm, Accelerated Idioventricular Rhythms, AIVR, Idioventricular Rhythm, Accelerated, Idioventricular Rhythms, Accelerated, Slow Ventricular Tachycardias, Slow Ventricular Tachycardia, Ventricular Tachycardia, Slow, Ventricular Tachycardias, Slow, Accelerated Idioventricular Rhythm [Disease/Finding], aivr, accelerated idioventricular rhythm (AIVR), accelerated idioventricular rhythm, accelerated idioventricular rhythm (diagnosis), Accelerated Idioventricular Rhythm by ECG Finding, ACCELERATED IDIOVENTRICULAR RHYTHM, Accelerated Idioventricular Rhythm by EKG Finding, Accelerated idioventricular rhythm, Accelerated idioventricular rhythm (disorder)
Swedish Tilltagande idioventrikulär rytm
Japanese ヒンミャクセイコユウシンシツチョウリツ, 加速自発性心室律動, 頻脈性固有心室調律, 促進固有心室調律
Czech zrychlený idioventrikulární rytmus, Akcelerovaný idioventrikulární rytmus
Finnish Idioventrikulaarinen takykardia
French Tachycardie idioventriculaire, Tachycardie ventriculaire lente, Rythme idioventriculaire accéléré, RIVA, Rythme idio-ventriculaire accéléré
Russian SERDTSA RITM IDIOVENTRIKULIARNYI USKORENNYI, СЕРДЦА РИТМ ИДИОВЕНТРИКУЛЯРНЫЙ УСКОРЕННЫЙ
Italian AIVR, Tachicardia ventricolare lenta, Ritmo idioventricolare accelerato
Polish Rytm komorowy przyspieszony, Częstoskurcz komorowy samorodny, Częstoskurcz komorowy nienapadowy, Rytm czynny
Hungarian Accelerált idioventricularis ritmus
Norwegian Økende idioventrikulær rytme
Spanish ritmo idioventricular acelerado (trastorno), ritmo idioventricular acelerado, Ritmo idioventricular acelerado, AIVR, Ritmo Idioventricular Acelerado
Portuguese Ritmo idioventricular acelerado, AIVR, Ritmo Idioventricular Acelerado
Dutch versneld idioventriculair ritme, Eigen-ventrikelritme, versneld, Ventrikelritme, versneld eigen-, Versneld eigen-ventrikelritme, Versneld idioventriculair ritme
German Akzelerierter idioventrikulaerer Rhythmus, AIVR, Beschleunigter ventrikulärer Eigenrhythmus, Eigenrhythmus, beschleunigter ventrikulärer, Ventrikulärer Eigenrhythmus, beschleunigter