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1/5. Accelerated ventricular rhythm in children: a review and report of a case with congenital heart disease.

    We report a child with accelerated ventricular rhythm (AVR) and congenital heart disease. Three children with congenital heart defect associated with AVR were previously reported, but in each AVR occurred only postoperatively. Because our patient's 24-hour electrocardiograph recording showed AVR rates, and differences between sinus and AVR rates, exceeding published childhood limits, we reviewed the topic. On the basis of our review, we suggest guidelines for diagnosing AVR and differentiating it from ventricular tachycardia. ( info)

2/5. Accelerated ventricular rhythm in the neonatal period: a review and two new cases in asymptomatic infants with an apparently normal heart.

    Accelerated ventricular rhythm (AVR) was observed in two newborn infants. In the first case, arrhythmia was noted during the foetal period. Both neonates were asymptomatic and had no evidence of cardiac disease. The arrhythmia eventually disappeared when the infants were 4 mo and 24 d old, respectively. AVR in the neonatal period is reviewed in this report and recent information regarding appropriate diagnostic evaluation, differentiation from ventricular tachycardia and treatment is outlined. Conclusion: Accelerated ventricular rhythm is a benign and self-limited arrhythmia in the neonatal period. However, it is important to differentiate it from other serious rhythm disorders, mainly ventricular tachycardia, in order to avoid unnecessary and potentially harmful treatment and to relieve parental anxiety. ( info)

3/5. accelerated idioventricular rhythm in a healthy teenager post circumcision.

    accelerated idioventricular rhythm (AIVR) is a ventricular arrhythmia, most commonly seen in adults with underlying cardiac disease. Few cases of AIVR have been reported in the adult population in the absence of cardiac pathology. We describe a case of a healthy teenager who developed episodes of AIVR postoperatively. Extensive evaluation with echocardiogram, cardiac MRI, exercise stress test, and Holter monitoring did not reveal any gross abnormalities except for mitral valve prolapse. Our patient was asymptomatic at all times and did not have any serious cardiac problems. ( info)

4/5. accelerated idioventricular rhythm detected during elective surgery in a healthy man.

    accelerated idioventricular rhythm (AIVR) is found most commonly in the presence of underlying heart disease. It is characterized by acceleration of a latent pacemaker that normally depolarizes slowly. We describe a 30-year-old man who was found to have episodes of accelerated idioventricular rhythm (AIVR) on cardiac monitoring during elective orthopedic surgery. Noninvasive evaluation including two-dimensional echocardiography was unremarkable. No late potentials were detected on a signal-averaged electrocardiogram. During an exercise tolerance test, AIVR was suppressed as heart rate increased. A 24-h Holter monitor revealed that the AIVR rate was consistently 73-76 beats/min, which appeared whenever the sinus rate slowed to this level. The patient has been asymptomatic, and the rhythm has persisted at least through a 5-month follow-up period. ( info)

5/5. Idioventricular rhythm: hypervagotonia associated with placebo.

    We report a case of hypervagotonia manifested by idioventricular rhythm in a healthy, athletic man who participated in a Phase I study of an investigational calcium-channel blocker. Upon breaking the study's double-blind study code, it was discovered that the subject had received placebo. We discuss this unusual finding and the implications of including athletic subjects in safety/tolerance studies. ( info)

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