Coronary Artery Disease - STEMI Case #2 - Question #3

She undergoes percutaneous coronary intervention to her right coronary artery without complication. Three hours later her rhythm changes, and the below ECG is obtained:

AcceleratedIdioventricular1

What is the appropriate management?

A. No treatment is required

B. Lidocaine infusion

C. Amiodarone infusion

D. Emergent cardioversion

 

An accelerated idioventricular rhythm is seen on this ECG. This is a common post-STEMI rhythm and is also termed “slow ventricular tachycardia” because it meets morphology criteria for VT but has a heart rate below 100 beats per minute. This is a benign, hemodynamically stable rhythm, and no treatment is necessary.