Acute Anterior Myocardial Infarction Complicated By Accelerated Idioventricular Rhythm Treatment

Accelerated idioventricular rhythm (AIVR), sometimes referred to as slow ventricular tachycardia, is characterized by a heart rate ranging between 60 and 100 beats per minute. This rhythm originates from the ventricles and generally does not cause hemodynamic instability or severe complications. AIVR is often observed in patients following acute myocardial infarction, thrombolytic therapy, or percutaneous coronary intervention (PCI), serving as a marker of reperfusion success. In most cases, this rhythm disturbance does not require antiarrhythmic drug therapy.

Understanding Arrhythmias in Acute Myocardial Infarction

Acute myocardial infarction (AMI) can lead to a variety of arrhythmias, including atrial premature contractions, ventricular premature contractions, atrial flutter, atrial fibrillation, ventricular tachycardia, and ventricular fibrillation. Among these, accelerated idioventricular rhythm is a common finding, especially in anterior wall myocardial infarction. These types of arrhythmias are typically benign and do not necessitate aggressive treatment. Instead, careful monitoring of the patient's clinical status is recommended to detect any potential changes.

Managing Hemodynamically Significant Arrhythmias

While AIVR itself is generally non-threatening, acute myocardial infarction—particularly anterior wall infarction—can also lead to more dangerous arrhythmias that impact hemodynamic stability. These include atrial flutter, atrial fibrillation, rapid ventricular tachycardia, and ventricular fibrillation. These arrhythmias require prompt attention and may necessitate pharmacologic intervention, such as the administration of amiodarone, to restore normal cardiac rhythm and prevent complications.

Key Treatment Strategies for Myocardial Infarction Patients

The cornerstone of managing patients with acute myocardial infarction is timely and effective reperfusion therapy. This involves rapidly and completely opening the infarct-related artery to restore blood flow to the affected myocardium. As ischemia improves, many arrhythmias tend to resolve spontaneously. Early intervention not only reduces arrhythmia risk but also improves overall patient outcomes, including long-term prognosis and quality of life.