Overview
Idioventricular Rhythm (IVR) is a cardiac rhythm disorder characterized by a slow heartbeat originating from the ventricles (the lower chambers of the heart) rather than the usual pacemaker in the sinoatrial node. It is often seen as a protective or escape rhythm when the normal conduction pathways fail. Although IVR can be benign and transient, it may also indicate underlying heart disease or damage. In Korea, cardiology departments and advanced cardiac care centers are well-equipped to diagnose and manage IVR with comprehensive monitoring and treatment strategies.
What is Idioventricular Rhythm?
Idioventricular Rhythm occurs when the ventricles take over as the heart’s pacemaker, usually at a rate of 20 to 40 beats per minute, which is slower than the normal sinus rhythm. This rhythm can be seen in conditions like heart attack (myocardial infarction), electrolyte imbalances, or after certain cardiac procedures. It may be a temporary compensatory mechanism or a sign of more severe conduction system disease.
Symptoms
- Often asymptomatic if heart rate is adequate
- Fatigue or weakness
- Dizziness or lightheadedness
- Shortness of breath
- Chest pain
- Syncope (fainting) in severe cases
Causes
- Acute myocardial infarction (heart attack)
- Digitalis toxicity
- Electrolyte abnormalities (e.g., hyperkalemia)
- Myocarditis
- Post-cardiac surgery or interventions
- Degeneration of the conduction system
Risk Factors
- Coronary artery disease
- Heart failure
- Previous heart attacks
- Use of certain medications (e.g., digitalis)
- Electrolyte disturbances
- Advanced age
Complications
- Progression to more severe arrhythmias (ventricular tachycardia or fibrillation)
- Reduced cardiac output leading to heart failure symptoms
- Sudden cardiac arrest in rare cases
Prevention
- Management of underlying heart disease
- Regular monitoring of cardiac function in high-risk patients
- Avoidance of medications that may provoke arrhythmias without supervision
- Control of electrolyte imbalances
Treatment Options in Korea
Diagnosis
- Electrocardiogram (ECG) – Identifies wide QRS complexes and slow ventricular rhythm
- Holter monitoring – Continuous ECG recording to assess frequency and duration
- Echocardiography – Evaluates heart function and structure
- Blood tests – Assess electrolyte levels and cardiac enzymes
Medical Treatments
- Monitoring if asymptomatic and stable
- Medications such as antiarrhythmics if rhythm causes symptoms or hemodynamic compromise
- Correction of underlying causes (electrolytes, ischemia)
- Temporary pacing in severe bradycardia or heart block
Surgical or Advanced Therapies
- Implantable pacemaker for persistent symptomatic IVR due to conduction system failure
- Catheter ablation in select arrhythmias related to ventricular foci
- Coronary interventions for ischemic heart disease
Rehabilitation and Support
- Cardiac rehabilitation programs post-myocardial infarction
- Lifestyle modifications to improve heart health (diet, exercise, smoking cessation)
- Regular cardiology follow-up and ECG monitoring
Top Hospitals or Clinics in Korea
- Seoul National University Hospital – Cardiology Department – Advanced arrhythmia diagnostics and treatments
- Asan Medical Center – Heart Institute – Comprehensive cardiac care including device implantation
- Samsung Medical Center – Cardiac Electrophysiology Unit – Specializes in arrhythmia management
- Yonsei Severance Hospital – Cardiovascular Center – Multidisciplinary cardiac services including rhythm disorders