The mechanism involves a decrease in the sympathetic but an increase in vagal tone. Īccelerated Idioventricular rhythm is also be rarely seen in patients without any evidence of cardiac disease. Idioventricular rhythm can also infrequently occur in infants with congenital heart diseases and cardiomyopathies such as hypertrophic cardiomyopathies and arrhythmogenic right ventricular dysplasia.

Various medications such as digoxin at toxic levels, beta-adrenoreceptor agonists like isoprenaline, adrenaline, anesthetic agents including desflurane, halothane, and illicit drugs like cocaine have reported being etiological factors in patients with AIVR. Įlectrolyte abnormalities can increase the chances of idioventricular rhythm. Idioventricular rhythm can also be seen during the reperfusion phase of myocardial infarction, especially in patients receiving thrombolytic therapy. It commonly presents in atrioventricular (AV) dissociation due to an advanced or complete heart block or when the AV junction fails to produce 'escape' rhythm after a sinus arrest or sinoatrial nodal block. Idioventricular rhythm can be seen in and potentiated by various etiologies. It is a hemodynamically stable rhythm and can occur after a myocardial infarction during the reperfusion phase. Īccelerated idioventricular rhythm (AIVR) results when the rate of an ectopic ventricular pacemaker exceeds that of the sinus node with a rate of around 50 to 110 bpm and often associated with increased vagal tone and decreased sympathetic tone. Idioventricular rhythm is similar to ventricular tachycardia, except the rate is less than 60 bpm and is alternatively called a 'slow ventricular tachycardia.' When the rate is between 50 to 110 bpm, it is referred to as accelerated idioventricular rhythm. When ventricular rhythm takes over, it is essentially called Idioventricular rhythm. When the sinoatrial node is blocked or suppressed, latent pacemakers become active to conduct rhythm secondary to enhanced activity and generate escape beats that can be atrial itself, junctional or ventricular. Idioventricular rhythm is a slow regular ventricular rhythm, typically with a rate of less than 50, absence of P waves, and a prolonged QRS interval.

Ecg junctional escape rhythm