Expert ECG 16
- Accelerated idioventricular rhythm
- AV disocciation
An idioventricular rhythm is very similar to ventricular tachycardia (VT), except the ventricular rate is less than 60. All other characteristics of ventricular tachycardia apply, including the Brugada criteria. This ECG has clear "AV dissociation" or "atrioventricular dissociation" meaning the P waves are at one rate and completely unrelated to the QRS rate. The QRS morphology in this ECG is of a left bundle branch block pattern and is monophasic downward in the precordial leads, another indicator of a ventricular origin of the rhythm. An idioventricular rhythm is frequently referred to as a "slow ventricular tachycardia” or “slow VT". When the ventricular rate is between 60-100, it is referred to as an accelerated idioventricular rhythm or AIVR. This is a hemodynamically stable rhythm that occurs commonly after myocardial infarction and no treatment is needed.