Accelerated idioventricular rhythm detected during elective surgery in a healthy man.
Accelerated idioventricular rhythm (AIVR) is found most commonly in the presence of underlying heart disease. It is characterized by acceleration of a latent pacemaker that normally depolarizes slowly. We describe a 30-year-old man who was found to have episodes of accelerated idioventricular rhythm (AIVR) on cardiac monitoring during elective orthopedic surgery. Noninvasive evaluation including two-dimensional echocardiography was unremarkable. No late potentials were detected on a signal-averaged electrocardiogram. During an exercise tolerance test, AIVR was suppressed as heart rate increased. A 24-h Holter monitor revealed that the AIVR rate was consistently 73-76 beats/min, which appeared whenever the sinus rate slowed to this level. The patient has been asymptomatic, and the rhythm has persisted at least through a 5-month follow-up period.
Lew
D C
DC
Department of Medicine, University of Florida, Gainesville.
Keim
S G
SG
Curtis
A B
AB
D016170:Accelerated Idioventricular Rhythm / Q000175:diagnosis* / Q000503:physiopathology*; D000328:Adult; D001283:Atrioventricular Node / Q000503:physiopathology; D004550:Elbow / Q000294:innervation*; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D009408:Nerve Compression Syndromes / Q000601:surgery*