II. Mechanism
- Benign transient Dysrhythmia (typically lasts minutes and resolves)
- Occurs after STEMI with coronary reperfusion (spontaneous or after PCI, Fibrinolysis)
III. Findings
- Regular wide complex rhythm (at least 3 consecutive beats)
- No P Waves (or P Waves with atrioventricular dissociation)
- Heart Rates typically 40 to 120 bpm
IV. Differential Diagnosis
- See Wide Complex Tachycardia
-
Ventricular Tachycardia
- Typically presents with Heart Rates >120-130
- Other causes
- Digoxin Toxicity
- Electrolyte abnormalities (e.g. Hyperkalemia)
- Cardiac ischemia
V. Management
- Observation of suspected AIVR rhythm only
- Antidysrhythmic medications may degenerate AIVR to Asystole
VI. References
- Berberian and Brady (2024) Crit Dec Emerg Med 38(3): 15