Riva U R, Budriesi N, Fancinelli M, Labriola E
Servizio di Cardiologia, Ospedale Civile, Bologna.
Cardiologia. 1994 Aug;39(8):591-6.
In the evaluation of an accelerated idioventricular rhythm (AIVR) case presented by an athlete, even though considered qualified for agonistic sport practice in compliance with the COCIS protocol, the authors made some considerations relative to such type of arrhythmia. AIVR are characterized by a wide oscillation of frequency (from 40 to 120 b/min) and are distinguished as active AIVR when the ventricular center exceeds the discharge frequency in a non depressed sinusal activity; and it's passive AIVR when an automatic ventricular center substitutes the physiological pacemaker in the presence of sinusal bradycardia. This leads to think that it could be two different phenomenons. The first is characterized by a low frequency and is determined by the activation of some automatic cells located under the His bundle, and the second arises with the extrasystolic modality. Moreover, AIVR manifest a parasystolic type of behaviour that complicates the diagnostic differentiation. Therefore it can be considered that the arrhythmia of ventricular genesis (AIVR, ventricular tachycardia, parasystole) represents the varied expression of the same electrogenic substratum with different discharge potentiality. Thus was formulated the proposal of unifying the ventricular rhythms in one group which includes: rhythm of ventricular escapement, AIVR, parasystole and ventricular tachycardia.
在评估一名运动员出现的加速性室性自主心律（AIVR）病例时，尽管根据COCIS协议该运动员被认为有资格参加竞技性体育活动，但作者对这种心律失常类型进行了一些思考。AIVR的特点是频率波动范围较大（40至120次/分钟），当心室中心在窦性活动未受抑制时超过放电频率时，被区分为主动性AIVR；而当自动心室中心在窦性心动过缓时替代生理性起搏器时，则为被动性AIVR。这使得人们认为可能存在两种不同的现象。第一种以低频为特征，由希氏束下方一些自动细胞的激活所决定，第二种则以早搏形式出现。此外，AIVR表现出一种并行心律类型的行为，这使得诊断鉴别变得复杂。因此，可以认为室性起源的心律失常（AIVR、室性心动过速、并行心律）代表了具有不同放电视能的同一电发生基质的不同表现形式。于是提出了将室性心律统一归为一组的提议，这一组包括：室性逸搏心律、AIVR、并行心律和室性心动过速。
