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ECG library

Accelerated idioventricular rhythm

advanced

Thirty minutes after primary PCI for inferior STEMI, a wide rhythm appears. BP 122/74.

25 mm/s · 10 mm/mV · synthetic tracing
100%
IIIIIIaVRaVLaVFV1V2V3V4V5V6
II (rhythm)
Calipers:2000 ms50.0 small boxes30 bpm if R-RDrag the orange markers. One small box = 40 ms.

Key findings

  • Wide regular rhythm at 60 to 100
  • Hemodynamically stable
  • Post-reperfusion context

Learning points

  • AIVR after PCI usually announces reperfusion, not deterioration; observe rather than suppress.
  • The rate separates it from VT: same morphology, different urgency.

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