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Updated: Apr 28, 2026

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Transient post-reperfusion left bundle branch block and accelerated idioventricular rhythm with paradoxical QRS
Irwin Hoffman1, Mark R Zolnick1, Christopher Bunn1
1Christus St. Vincent Hospital, Santa Fe, NM; Department of Medicine University of New Mexico Albuquerque, NM.
Abstract:
Accelerated idioventricular rhythm (AIVR) commonly follows coronary reperfusion and has been called a "reperfusion arrhythmia". Transient left bundle branch block (LBBB) is only rarely seen after interventional reperfusion and is usually considered a procedural complication. We report herein electrocardiograms (ECGs) in a case of acute lateral myocardial infarction which demonstrate both post-perfusion AIVR and a simultaneous transient LBBB with fusion complexes causing paradoxical QRS narrowing.
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