Introduction

We, herein report 2 case reports of accelerated idioventricular rhythm (AIVR) in young healthy individuals.

Case reports

Our first case is a 20-year-old man who is a candidate soldier with no medical history. He was referred to our center with electrocardiogram (ECG) findings, which is seen in routine control before sportive activity. His baseline ECG showed accelerated idioventricular rhythm. His family history was unremarkable. On admission, his blood pressure was 125/75 mmHg and the pulse rate was 68 bpm. Physical examination was unremarkable. The echocardiogram showed a structurally and functionally normal heart. During exercise tolerance test, AIVR was suppressed due to the increase of heart rate. A 24-h Holter monitor revealed that 67% of total 81916 beats were sustained and non sustained AIVR(Figure 1), which appeared whenever the sinus rate slowed. An electrophysiological study (EPS) showed normal parameters. After atropine infusion AIVR was suppressed as heart rate was increased. A cardiac MRI was also performed and revealed normal cardiac functions. He was discharged with no medication. He has been followed for 2 years uneventfully.

Our second case is a 20-year-old man who is a candidate soldier with no medical history. He was referred to our clinic for atypical chest pain. His baseline ECG showed a non sustained AIVR. Physical examination was unremarkable and echocardiography showed normal findings. During exercise tolerance test, AIVR was suppressed as heart rate increased. A 24-h Holter monitor revealed that 54% of total beats were sustained and nonsustained AIVR (Figure 2). EPS and cardiac MRI were also performed and showed normal cardiac functions. He was asymptomatic and discharged with no medication. The patient has also been followed for 8 months uneventfully.