Idioventricular Rhythm 

Idioventricular Rhythm


Originating in a ventricle. idioventricular rhythm [Gk, idios, own; L, ventriculus, little belly; Gk, rhythmos], an independent cardiac rhythm caused by a repeated discharge of impulses at a rate of less than 100 beats/ min from a focus within a ventricle. Mosby (2009- 02-11).


Characteristics

Rate Ventricular rate 20-40 BPM 

Rhythm Ventricular rhythm is regular 

P-Waves Usually absent or with retrograde conduction to the atria, may appear after the QRS.


PR Interval None

QRS Duration 0.12 sec (3 small boxes) or greater, wide and bizarre.


MEDS

Epinephrine 1:10,000 IVP every 3-5 min
 Followed by 20ml flush of NS


Treatment


If Pulses are Present

Monitor Diagnostic 12 lead


Oxygen 15 LPM NR Mask


IV 18g


May Attempt Transcutaneous Pacing 


If Pulseless (PEA)

CPR >2 inches, 100 BPM Rotate every
2 minutes 30:2 Vent to Breath ratio 

Consider Possible Causes 5 H’s and 5 T’s 

IV or IO 18g or larger at AC or higher 

Administer Meds
 Epinephrine 1:10,000 IVP every 3-5 min Followed by 20ml flush of NS


Advanced Airway Utilize quantitative waveform capnography


Noticeable by: 

3 or more Ventricular escape occur in a row at a rate of 20-40 BPM QRS Complex is Wide and Bazaar. Less than 20 BPM is Agonal Rhythm or Dying Heart

© Matt Dillard 2012