Which of the following best describes an idioventricular rhythm?

Question

a. Rapid, chaotic rhythm with no pattern or regularity
b. Gradual alteration in the amplitude and direction of the QRS; atrial rate indiscernible; ventricular rate 150 to 250 beats/min
c. Essentially regular ventricular rhythm with QRS complexes measuring 0.12 seconds or greater; atrial rate not discernible; ventricular rate 20 to 40 beats/min
d. Regular ventricular rhythm with QRS complexes measuring less than 0.10 seconds; P waves may occur before, during, or after the QRS; ventricular rate 40 to 60 beats/min

Answer 1

C
An idioventricular rhythm (IVR), which is also called a ventricular escape rhythm, exists when three or more ventricular escape beats occur in a row at a rate of 20 to 40 beats/min (i.e., the intrinsic firing rate of the Purkinje fibers). The QRS complexes seen in IVR are wide and bizarre because the impulses begin in the ventricles, bypassing the normal conduction pathway. When the ventricular rate slows to a rate of less than 20 beats/min, some practitioners refer to the rhythm as an agonal rhythm or dying heart.