Accelerated Idioventricular Rhythm: History and Chronology of the Main Discoveries

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Abstract

Accelerated Idioventricular Rhythm (AIVR) is a ventricular rhythm consisting of three or more consecutive monomorphic beats, with gradual onset and gradual termination. It can rarely manifest in patients with completely normal hearts or with structural heart disease. It is usually seen during acute myocardial infarction reperfusion. This manuscript aims to review the history of the main discoveries that lead to the identification and comprehension of this fascinating arrhythmia.

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Most cited references 42

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Delayed development of ventricular ectopic rhythms following experimental coronary occlusion.

Maximilian A. T. S. Harris (1950)

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Five cases of aconite poisoning: toxicokinetics of aconitines.

K Oikawa, Yuji Fujita, Norio Sato … (2007)

Aconite poisoning was examined in five patients (four males and one female) aged 49 to 78 years old. The electrocardiogram findings were as follows: ventricular tachycardia and ventricular fibrillation in case 1, premature ventricular contraction and accelerated idioventricular rhythm in case 2, AIVR in case 3, and nonsustained ventricular tachycardia in cases 4 and 5. The patient in case 1 was given percutaneous cardiopulmonary support because of unstable hemodynamics, whereas the other patients were treated with fluid replacement and antiarrhythmic agents. The main aconitine alkaloid in each patient had a half-life that ranged from 5.8 to 15.4 h over the five cases, and other detected alkaloids had half-lives similar to the half-life of the main alkaloid in each case. The half-life of the main alkaloid in case 1 was about twice as long as the half-lives in the other cases, and high values for the area under the blood concentration-time curve and the mean residence time were only observed in case 1. These results suggest that alkaloid toxicokinetics parameters may reflect the severity of toxic symptoms in aconite poisoning.

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Reperfusion arrhythmia: a marker of restoration of antegrade flow during intracoronary thrombolysis for acute myocardial infarction.

P Maroko, Caren Goldberg, P Urban … (1982)

We studied the effects of coronary recanalization on arrhythmogenesis in patients undergoing intracoronary thrombolysis during the early hours of myocardial infarction. Catheterization, ventriculography, coronary angiography, and intracoronary streptokinase infusion were performed in 22 patients. Twenty-one of 22 had thrombotic total occlusion of the infarct-related transient thrombolysis with reocclusion by the end of the procedure. In 12 of these 17 patients, restoration of antegrade coronary flow was accompanied by transient arrhythmia. In these 12 patients coronary angiography within seconds of onset of arrhythmia showed vessel patency in a previously totally occluded coronary artery. Two additional patients developed arrhythmias during streptokinase infusion but after reperfusion had already been established. Accelerated idioventricular rhythm was most often noted. Sinus bradycardia and atrioventricular block with hypotension occurred during restoration of flow in arteries supplying the inferoposterior left ventricle. These arrhythmias may be useful noninvasive markers of successful reperfusion during thrombolytic therapy in acute myocardial infarction.

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Author and article information

Journal

Journal ID (nlm-ta): Indian Pacing Electrophysiol J

Journal ID (publisher-id): Indian Pacing Electrophysiol J

Title: Indian Pacing and Electrophysiology Journal

Publisher: Indian Heart Rhythm Society

ISSN (Electronic): 0972-6292

Publication date Collection: 2010

Publication date (Electronic): 07 January 2010

Volume: 10

Issue: 1

Pages: 40-48

Affiliations

[1 ]ABC Medical Faculty. ABC Foundation. Santo Andre - Sao Paulo. Brazil

[2 ]Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza-Ceara-Brazil

[3 ]Kingston General Hospital, Queen's University, Kingston, Ontario, Canada

Author notes

Address for correspondence: Andres Ricardo Perez Riera MD, Sebastiao Afonso, 885CEP: 04417-000 - Jardim Miriam - Sao Paulo - Brazil. E-mail: riera@ 123456uol.com.br

Article

Publisher ID: ipej100040-00

PMC ID: 2803604

PubMed ID: 20084194

SO-VID: 6cd0dcc9-d3ab-415a-a490-c2fb7b8b85ac

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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Accelerated Idioventricular Rhythm: History and Chronology of the Main Discoveries

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Abstract

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Cardiovascular Innovations and Applications

Most cited references 42

Delayed development of ventricular ectopic rhythms following experimental coronary occlusion.

Five cases of aconite poisoning: toxicokinetics of aconitines.

Reperfusion arrhythmia: a marker of restoration of antegrade flow during intracoronary thrombolysis for acute myocardial infarction.

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