AIVR... where does the focus come from? LV?

[pinipig523]

Hey guys -

Question, I'm reviewing my ekgs and using Mattu's book. Looking at AIVR, post-reperfusion from an AMI - where does the conduction originate from?

Does it come from the LV?

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[RustedFox]

Oddly enough, I thought the same thing, and concluded that it HAD to be either junctional or below.

Also; you PM'ed me awhile back about the medicolegal rotation. I'm maybe a few days away from finishing that paper. I'll PM you soon to give you a heads-up.

 

[pinipig523]

Can an ectopic AIVR focus be from the RV or is it always from LV? I dunno...

I was looking at #138 and it shows an Rsr in v1 which means that the ectopic focus is from LV... usually a RBBB will have an rsR in v1.

I don't know if that means that an Rsr in v1 is a prerequisite to an AIVR.

Btw, thanks RF!

 

[Arcan57]

Can an ectopic AIVR focus be from the RV or is it always from LV? I dunno...

I was looking at #138 and it shows an Rsr in v1 which means that the ectopic focus is from LV... usually a RBBB will have an rsR in v1.

I don't know if that means that an Rsr in v1 is a prerequisite to an AIVR.

Btw, thanks RF!

I've seen reperfusion rhythms that had a LBBB appearance, so I don't think it's exclusive. My guess is that it's likely to come from whatever ventricle just infarcted, but I have nothing to support that. The main thing with recognizing a reperfusion rhythm is the patient looks great and the rate is under 120.

 

[pinipig523]

I've seen reperfusion rhythms that had a LBBB appearance, so I don't think it's exclusive. My guess is that it's likely to come from whatever ventricle just infarcted, but I have nothing to support that. The main thing with recognizing a reperfusion rhythm is the patient looks great and the rate is under 120.

Gotcha... thanks!