Accelerated Idioventricular Rhythm (AIVR) is the most common arrhythmia associated with:
Correct Answer: Myocardial Reperfusion
Description: Answer is B (Myocardial Reperfusion) Accelerated Idioventricular Rhythm is the most common arrhythmia seen after successful reperfusion of a blocked coronary vessel and hence is often also termed as a `reperfusion rhythm or reperfusion arrhythmia'. 'Arrhythmias are common after reperfusion. The most common post reperfusion arrhythmia is Accelerated Idioventricular Rhythm (AIVR)' - Problem Oriented Approach in Interventional Cardiology 'Accelerated Idioventricular Rhythm is considered a reperfusion rhythm as it is often seen immediately after a successful reperfusion' - Washington manual of critical care /116 Myocardial Reperfusion, Dilated cardiomyopathy, Digitalis matoxication and Myocarditis may all produce Accelerated Idioventricular Rhythms (AIVR), however AIVR is the most common arrhythmia seen after myocardial Reperfusion. AIVR is also the most charachteristic arrhythmia seen after reperfusion has begun and hence Myocardial Reperfusion is the single best answer of choice. Accelerated Idioventricular Rhythm (AIVR) AIVR is an automatic rhythm originating within the ventricle with rates between 40 to,120 beats / min AIVR is believed to be caused by abnormal automaticity and is considered to be a brief self limiting arrhythmia , that does not usually require any specific treatment unless the patient is symptomatic The onset of this arrhythmia is gradual (non paroxysmal) and occurs when the rate of ventricular tachycardia exceeds the sinus rate because of sinus slowing or SA / AV block AIVR is a characteristic feature of myocardial reperfusion, and when it occurs in the setting of myocardial infarction and coronary reperfusion it is also called Reperfusion Arrhythmia' or Reperfusion Rhythm'. `It commonly occurs at the moment of reperfusion of an occluded coronaryaery' - Braunwald AIVR can be seen in the absence of any structural hea disease but is usually seen in patients who have an underlying structure hea disease. 0.12 sec) (Bizzare) * Fusion beats * Capture beats * AV dissociation * Rhythm: Regular " align="left" height="94" width="226">Treatment of Accelerated Idioventricular Rhythm No specific treatment is usually required (No treatment in Asymptomatic patients) Since the ventricular rate usually ranges the same as sinus rhythm, hemodynamic compromise does not occur Also the condition is self limiting and transient and does not appear to affect the patients clinical course or prognosis. Hence no specific treatment is required although these patients should be observed Symptomatic patients Is ith Hemods namic compromise may require treatment Atropine or Atrial pacing may suppress the AIVR by simply increasing the sinus rate Lidocaine may be used for suppressive therapy
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