Accelerated idioventricular rhythm as a presentation of neonatal myocarditis: A case report

• Published in: Progress in pediatric cardiology Vol. 76; p. 101804
• Main Authors: Yenduri, Naimisha, Saravanan, Sakthi, Sasikumar, Navaneetha, Kumar, Raman Krishna
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.03.2025
• Subjects: Accelerated idioventricular rhythm; Neonatal myocarditis; Non-sustained ventricular tachycardia; Pediatric arrhythmia; CRP; Accelerated idioventricular rhythm; Neonatal myocarditis; VPC; ECG; Non-sustained ventricular tachycardia; Pediatric arrhythmia; AIVR; VT; CPK
• DOI: 10.1016/j.ppedcard.2024.101804
• ISSN: 1058-9813

Accelerated ventricular rhythm is well-recognized in adults and is frequently reported with reperfusion post-infarction. It is rare in newborns. We present a case of presumed neonatal myocarditis likely secondary to maternal viral infection, presenting with an accelerated idioventricular rhythm. This was diagnosed as non-sustained ventricular tachycardia. The baby was started on a beta blocker for the same, which paradoxically increased the duration and frequency of the rhythm. Once the nature of the arrhythmia was identified to be accelerated idioventricular rhythm, the beta-blocker was stopped. This, as well as the gradual resolution of inflammation, resulted in quiescence of the arrhythmia. Accelerated idioventricular rhythm can be the presentation of neonatal myocarditis. Prompt identification can help in avoiding unnecessary therapy for this generally benign and self-limiting arrhythmia. •Differentiating Accelerated Idioventricular Rhythm from Ventricular Tachycardia is important, given that the former is generally benign.•Benign but Significant: While AIVR is typically self-limiting, its presence can be a sign of serious underlying conditions like myocarditis.•This case highlights the importance of conservative management while ensuring diagnostic vigilance to avoid unnecessary interventions.