Retrograde Conduction of AIVR: From the Second Beat Onward
Report:
Sinus rhythm 75/min
PR interval 0.20â
Intraventricular conduction delay, probably LBBB
QRS 0.12â
Accelerated idioventricular rhythm (AIVR) 96/min
Retrograde VA conduction
RP interval 0.20â
Comment:
The retrograde and antegrade conduction times are usually identical or very similar. Note how the retrograde P wave appears following the second beat of the AIVR. This is because the blocked sinus beat renders the AV node refractory. The penultimate QRS in the top strip actually shows the blocked sinus P wave in its ST segment; the last QRS has retrograde conduction. While in some situations retrograde conduction starts after the onset of AIVR or VT because the faster rate favours conductivity, in most cases the delay is due to the last sinus P wave blocking the way.
DyspnÅa may have been due, at least in part, to the hæmodynamically unfortunate timing of the retrograde P waves.
174. 72 year old man with recurrent palpitations.
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and its records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.