Idioventricular rhythm
Also calledIVR · ventricular escape rhythm · idioventricular escape rhythm
Definition
A ventricular escape rhythm: a slow rhythm that originates in the ventricles, below the bundle of His, and takes over when higher (sinus or junctional) pacemakers are inhibited or their impulses are blocked. Its rate is usually under 40 bpm (20 to 40 bpm in one teaching algorithm), and its QRS complexes are wide. When it escapes during complete AV block, the sinus P waves continue at a faster rate with no relationship to the QRS complexes (AV dissociation). A ventricular escape rhythm is slower and less reliable than a junctional escape rhythm.
Sources
- Samesima N, God EG, Kruse JCL, et al. Brazilian Society of Cardiology guidelines on the analysis and issuance of electrocardiographic reports - 2022. Arq Bras Cardiol. 2022;119(4):638-680. doi.org/10.36660/abc.20220623
- Ashkanani AA, Ashkanani AH, Alkandari MF, et al. An accessible algorithm for the quick and precise interpretation of atrioventricular blocks in electrocardiograms. Ann Noninvasive Electrocardiol. 2026;31(4):e70207. doi.org/10.1111/anec.70207
- Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay. Circulation. 2019;140(8):e382-e482. doi.org/10.1161/CIR.0000000000000628
Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.