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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Understanding Idioventricular Rhythm
Introduction
Idioventricular rhythm (IVR) is a type of abnormal heart rhythm that originates in the ventricles (the lower chambers of the heart) when the usual pacemaker of the heart (the sinoatrial node) is not functioning properly. It is a slow, regular rhythm with a rate typically between 30-50 beats per minute.
Causes of Idioventricular Rhythm
- Myocardial infarction (heart attack)
- Electrolyte imbalances (e.g., low potassium or magnesium levels)
- Drug toxicity (e.g., digoxin, antiarrhythmics, or anesthetics)
- Heart disease (e.g., cardiomyopathy, conduction system disease)
- Post-resuscitation states
Clinical Significance
In most cases, IVR is a benign rhythm that does not cause serious problems. However, in some situations, it can indicate significant heart disease or myocardial ischemia.
Types of IVR:
- Accelerated Idioventricular Rhythm (AIVR): A slightly faster form (50-110 bpm), often seen after a heart attack or with reperfusion therapy.
- Standard Idioventricular Rhythm: A slower rhythm (30-50 bpm), commonly seen when higher pacemakers fail.
Symptoms
- Fatigue
- Dizziness or lightheadedness
- Shortness of breath
- Palpitations (sometimes)
- May be asymptomatic
Diagnosis
IVR is diagnosed using an electrocardiogram (ECG), which will show: - Wide QRS complexes (≥120 ms) - Regular rhythm - No preceding P waves (or dissociated P waves) - Rate between 30-50 bpm
Treatment
Idioventricular rhythm often does not require treatment if the patient is stable. However, if symptoms occur, treatment includes: 1. Identifying and treating the underlying cause (e.g., correcting electrolyte imbalances, stopping medications causing toxicity) 2. Atropine (may be used if the heart rate is too slow and causing symptoms) 3. Pacing (if severe bradycardia is present and symptomatic)
Conclusion
Idioventricular rhythm is generally a slow, ventricular-origin rhythm that can occur due to heart disease, medication effects, or other conditions. Understanding its characteristics helps in differentiating it from more serious arrhythmias and managing it appropriately.
Source recommendations
1. American Heart Association (AHA) Guidelines on Cardiac Arrhythmias
- https://www.heart.org/en/health-topics/arrhythmia
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
- https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
- https://pubmed.ncbi.nlm.nih.gov/29097294/
2. European Society of Cardiology (ESC) Guidelines on Management of Ventricular Arrhythmias
- https://academic.oup.com/eurheartj/article/43/40/3997/6675633
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
- https://pubmed.ncbi.nlm.nih.gov/36017572/
- https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/09/02/14/23/2022-ESC-Guidelines-for-VAs-ESC-2022
- https://pubmed.ncbi.nlm.nih.gov/26320108/
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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