Question:
Accelerated idioventricular rhythm (AIVR) is the most common arrhythmia associated with:
Accelerated idioventricular rhythm (AIVR) is the most common arrhythmia associated with:
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AIVR is famous as the reperfusion arrhythmia after a blocked artery reopens.
Updated On: Jun 24, 2026
- Dilated cardiomyopathy
- Myocardial reperfusion
- Digitalis intoxication
- Myocarditis
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The Correct Option is B
Solution and Explanation
Step 1: Define AIVR. Accelerated idioventricular rhythm is a regular wide-complex ventricular rhythm at a rate of about 40 to 120 per minute. It arises from an enhanced ventricular focus when sinus rate slows.
Step 2: Recall its main clinical setting. AIVR is the classic and most common arrhythmia of successful myocardial reperfusion, for example after thrombolysis or angioplasty for an acute myocardial infarction. It is often called a reperfusion arrhythmia. So option B is correct.
Step 3: Note that AIVR is usually benign, transient, well tolerated, and does not need specific treatment. Its appearance after clot lysis is a useful marker that the artery has reopened.
Step 4: Why the others are wrong. Dilated cardiomyopathy is linked more with ventricular tachycardia and atrial fibrillation, not AIVR as the most common rhythm (option A wrong). Digitalis toxicity classically causes paroxysmal atrial tachycardia with block, bidirectional VT, and various ectopics (option C wrong). Myocarditis causes a range of arrhythmias and conduction blocks but AIVR is not its signature rhythm (option D wrong).
Step 5: AIVR is the hallmark reperfusion arrhythmia.
Answer: B. Myocardial reperfusion.
Step 2: Recall its main clinical setting. AIVR is the classic and most common arrhythmia of successful myocardial reperfusion, for example after thrombolysis or angioplasty for an acute myocardial infarction. It is often called a reperfusion arrhythmia. So option B is correct.
Step 3: Note that AIVR is usually benign, transient, well tolerated, and does not need specific treatment. Its appearance after clot lysis is a useful marker that the artery has reopened.
Step 4: Why the others are wrong. Dilated cardiomyopathy is linked more with ventricular tachycardia and atrial fibrillation, not AIVR as the most common rhythm (option A wrong). Digitalis toxicity classically causes paroxysmal atrial tachycardia with block, bidirectional VT, and various ectopics (option C wrong). Myocarditis causes a range of arrhythmias and conduction blocks but AIVR is not its signature rhythm (option D wrong).
Step 5: AIVR is the hallmark reperfusion arrhythmia.
Answer: B. Myocardial reperfusion.
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