AIVR in Anterior Infarction

Report:

Accelerated idioventricular rhythm 72/min

Supraventricular capture beats

Ventricular fusion beats (middle of the trace)

Acute extensive anterior infarction

Comment:

AIVR is commoner in inferior than anterior infarcts, but reperfusion tends to even this score in recent times.

The AIVR in this case had no hæmodynamic impact and was (wisely) left untreated. Its beats have a LBBB morphology except for the slow S descent in V1 QS complexes. The latter fact, together with two junctional-ventricular fusion beats in the middle of the tracing, prove the ventricular origin of the AIVR. A lone sinus capture terminates the recording.

The next day’s trace is shown below (Fig 17a): not very promising.

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