Accelerated Idioventricular Rhythm

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.

Also Known As:

Networked: 70 relevant articles (1 outcomes, 4 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Ventricular Tachycardia
2.	Accelerated Idioventricular Rhythm
3.	Myocardial Infarction
4.	Cardiac Arrhythmias (Arrythmia)
5.	Ventricular Premature Complexes (Premature Ventricular Contraction)

Experts

1.	Baan, Jan: 2 articles (08/2011 - 12/2010)
2.	Delewi, Ronak: 2 articles (08/2011 - 12/2010)
3.	Piek, Jan J: 2 articles (08/2011 - 12/2010)
4.	Remmelink, Maurice: 2 articles (08/2011 - 12/2010)
5.	Mewis, Christian: 2 articles (07/2006 - 11/2002)
6.	Aliot, Etienne: 2 articles (08/2005 - 12/2003)
7.	Schöls, Wolfgang: 2 articles (08/2005 - 08/2004)
8.	Mletzko, Ralph: 2 articles (08/2005 - 12/2003)
9.	Sadoul, Nicolas: 2 articles (08/2005 - 12/2003)
10.	Seidl, Karlheinz: 2 articles (08/2004 - 12/2003)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Accelerated Idioventricular Rhythm:

1.	glucuronyl glucosamine glycan sulfate (Vessel)IBA 08/01/2000 - "The ECG test that performed best as a positive test for < TIMI 3 flow in the infarct related vessel was < 50% resolution of the ST segment elevation in the worst lead and no accelerated idioventricular rhythm. " 06/01/1992 - "In patients with a patient infarct-related artery as assessed angiographically at 90 minutes, the occurrence of accelerated idioventricular rhythms was noted significantly more frequently than in patients with a permanent occluded vessel. " 10/01/1988 - "Other rhythm disturbances, including accelerated idioventricular rhythm, did not correlate with a change in the perfusion status of the vessel. " 08/01/1991 - "In patients with accelerated idioventricular rhythm after thrombolysis the infarct-related vessel is almost certain to be patent; but the infarct-related coronary artery can still be patent when no arrhythmia is seen." 08/01/1991 - "Coronary angiography showed a patent infarct-related vessel in 12 (92%) of the 13 patients with accelerated idioventricular rhythm (95% confidence interval 66 to 99%), in 22 (50%) of the 44 patients without accelerated idioventricular rhythm (95% CI 34 to 66%), in 11 (73%) of the 15 patients with non-sustained ventricular tachycardia (95% CI 45 to 92%), and in 23 (55%) (95% CI 39 to 71%) of the 42 patients who did not have non-sustained ventricular tachycardia. "
2.	bipiperidyl mustard (BPM)IBA 08/01/2011 - "AIVR caused an immediate reduction in SBP (130±27 vs. 98±22 mmHg, p<0.001) and DBP (80±19 vs. 69±16 mmHg, p<0.001) and a small increase in heart rate (78±12 vs. 83±11 bpm, p<0.001) as compared to sinus rhythm, irrespective of infarct-related artery. " 01/01/2013 - "The patient had a documented slow ventricular tachycardia (VT), and the device was programmed to detect VT at rates >100 bpm, fast VT (FVT, via VT) at rates >150 bpm, and ventricular fibrillation (VF) at rates >188 bpm. " 08/01/1993 - "During the early postoperative period low cardiac output with right atrial pressures of 20 mm Hg developed due to a slow ventricular tachycardia (ventricular rate 135 bpm). " 02/04/2014 - "Innovative programming of implantable cardioverter-defibrillators with therapy for ventricular tachycardia ≥200 bpm or a long delay is not associated with increased risk of arrhythmogenic or all-cause syncope, and syncope caused by slow ventricular tachycardias (<200 bpm) is a rare event. "
3.	Verapamil (Calan)FDA LinkGeneric 07/01/1983 - "Verapamil caused no change in the rate of AIVR in 1 patient, but in a second patient it decreased the rate by 20 beats/min. In 4 patients, verapamil abolished the arrhythmia: in 2 patients carotid sinus pressure (induced sinus slowing) allowed the emergence of the AIVR at a lower rate, and in the remaining 2 patients the arrhythmia was not observed." 07/01/1983 - "Intravenous verapamil (3 to 5 mg bolus) was administered to 6 patients with multiform AIVR in whom the arrhythmias were persistent enough to allow the evaluation of the effect of verapamil on the arrhythmia. " 07/01/1983 - "Multiform accelerated idioventricular rhythm in acute myocardial infarction: electrocardiographic characteristics and response to verapamil." 12/01/1998 - "Slow ventricular tachycardia located in the epicardium of the left ventricular base and characterized by effects of adenosine triphosphate, nicorandil and verapamil."
4.	Mexiletine (Mexitil)FDA LinkGeneric 08/01/1984 - "The number of all VPBs (P less than 0.05), hours with occurrence of AIVR (P less than 0.05), runs (P less than 0.01) and Ron T beats (P less than 0.05) was smaller in the mexiletine than in the placebo group. " 08/01/1984 - "The number of patients who had any event of accelerated idioventricular rhythm (AIVR; P less than 0.05) runs of ventricular premature beats (VPBs; P less than 0.01), ventricular tachycardia (P less than 0.01) and Ron T beats (P less than 0.05) was smaller in the mexiletine group than in the placebo group. " 06/01/1993 - "Combination treatment with aprindine (0.1 mg/kg/min for 10 min) and mexiletine (0.3 mg/kg/min for 5 min) enhanced antiarrhythmic effects of a single treatment of aprindine (0.1 mg/kg/min for 10 min) on digitalis and 24-h two-stage coronary ligation-induced arrhythmia models, but in the 48-h two-stage coronary ligation-induced arrhythmia model, a slow ventricular tachycardia (VT) model, addition of mexiletine to aprindine caused no enhancement of antiarrhythmic effects. "
5.	Glucose (Dextrose)FDA LinkGeneric 09/01/1992 - "A case of slow ventricular tachycardia occurring in a 65-year-old man with a dilated cardiomyopathy following an accidental overdose of naftidrofuryl (2 x 200 mg ampules in 250 ml of 5% glucose solution in 2 hours) prescribed for complicated arterial disease of the lower limbs is reported. " 01/01/2012 - "Herein, we report a patient with accelerated idioventricular rhythm (AIVR) due to hyperkalemia, which was successfully treated with glucose-insulin (GI) infusion."
6.	Epinephrine (Adrenaline)FDA LinkGeneric 09/01/2007 - "AIVR patients had longer total CPR duration (32 vs. 18 min) and higher dose of epinephrine use (10 vs. 3 mg). " 11/05/1982 - "Immediately after intravenous (IV) injections of epinephrine chloride, ventricular premature beats and apparent accelerated idioventricular rhythm occurred in one patient and possible ventricular tachycardia occurred in the other. "
7.	Creatine Kinase (Creatine Phosphokinase)IBA 02/01/1990 - "After reperfusion, all animals developed an accelerated idioventricular rhythm and high creatine kinase (CPK) plasma levels. " 08/01/2003 - "Serum level of creatine phosphokinase (9,835IU/L) and myocardium-derived troponin T (3.24 ng/mL) were elevated, and the ECG showed atrioventricular dissociation and accelerated idioventricular rhythm. "
8.	Captopril (Capoten)FDA LinkGeneric 03/11/1988 - "Upon reperfusion, an accelerated idioventricular rhythm occurred, both in 10 untreated and in 10 captopril-treated animals. " 07/01/1994 - "The incidence of accelerated idioventricular rhythm and non-sustained ventricular tachycardia in captopril patients was lower than in placebo patients (P < 0.05), parallelled by transiently lower norepinephrine levels (P < 0.05) upon thrombolysis.(ABSTRACT TRUNCATED AT 250 WORDS)"
9.	Anti-Arrhythmia AgentsIBA 10/15/1992 - "An accelerated idioventricular rhythm persisted in 1 horse for at least 8 months and failed to respond to antiarrhythmic drugs. " 05/01/1990 - "Different antiarrhythmic drugs were successfully used in twelve patients (the four patients with accelerated idioventricular rhythm were not treated). "
10.	tranilast (N 5')IBA 12/01/2010 - "Immediate effects of pPCI on LV function were compared between patients with (n = 5) and without (n = 10) occurrence of AIVR after reperfusion, as well as the direct effects of AIVR on LV function compared to sinus rhythm. " 12/01/2010 - "A total of 77 patients met inclusion criteria and were grouped as follows: accelerated idioventricular rhythm (AIVR; n = 19), right ventricular tachycardia (RVT; n = 30), left ventricular tachycardia (LVT; n = 23), and catecholamine sensitive polymorphic VT (CPVT; n = 5). "

Therapies and Procedures

1.	Implantable Defibrillators (Implantable Cardioverter-Defibrillator) 12/01/2003 - "Safety and efficacy of a dual chamber implantable cardioverter defibrillator capable of slow ventricular tachycardia discrimination: a randomized study." 08/16/2005 - "This study aims to assess the incidence and clinical relevance of slow ventricular tachycardia (VT) and the effectiveness and/or deleterious effects of antitachycardia pacing in slow VT in implantable cardioverter-defibrillator recipients. " 08/31/2004 - "The 1+1 trial: a prospective trial of a dual- versus a single-chamber implantable defibrillator in patients with slow ventricular tachycardias." 11/01/2009 - "[Interruption of slow ventricular tachycardia below the detection rate of implantable cardioverter-defibrillators]." 07/01/2006 - "In this case report, we present a 57-year-old patient who suffered from incessant slow ventricular tachycardia because of a change in therapy 2 weeks after the implantation of an implantable cardioverter defibrillator (ICD) with Home Monitoring (HM). "
2.	Defibrillators (Defibrillator) 11/01/2007 - "Electrophysiological study and 'slow' ventricular tachycardia predict appropriate therapy: results from a single-centre implantable cardiac defibrillator follow-up."
3.	Thrombolytic Therapy 11/01/1992 - "The reperfusion criteria was the early enzymatic rise of the CKMB activity levels (< or = 12 h) combined with a 50% or more reduction in the ST segment elevation within the first hour after thrombolytic therapy and the presence of an accelerated idioventricular rhythm at the same time. " 02/01/1988 - "Usefulness of the accelerated idioventricular rhythm as a marker for myocardial necrosis and reperfusion during thrombolytic therapy in acute myocardial infarction." 02/01/1985 - "Accelerated idioventricular rhythm appears to be the most specific arrhythmia encountered with thrombolytic therapy of acute myocardial infarction. " 07/01/1997 - "Variables related to high risk for in-hospital death in 1982 were higher age, low systolic blood pressure, atrial fibrillation, absence of accelerated idioventricular rhythm, sustained ventricular tachycardia and signs of left ventricular dysfunction; in 1988 the occurrence of non-sustained ventricular tachycardia, Killip class more than I, the absence of thrombolytic therapy, percutaneous transluminal coronary angioplasty or coronary artery bypass grafting were independently related to in-hospital death. "
4.	Cardiac Resynchronization Therapy 03/01/2010 - "Soon after an upgrade from a single-chamber implantable cardioverter-defibrillator (ICD) to cardiac resynchronization therapy (CRT) with an ICD, a 64-year-old man with non-ischaemic cardiomyopathy began to have increasingly frequent ICD shocks for slow ventricular tachycardia (VT). "
5.	Transplants (Transplant) 04/01/2000 - "During 32 +/- 15-month prospective follow-up, no significant difference was observed for major arrhythmic events and transplant-free survival between patients with and without accelerated idioventricular rhythm, whereas patients with nonsustained ventricular tachycardia had a significantly higher incidence of major arrhythmic events and a lower transplant-free survival rate."