# Accelerated idioventricular rhythm as a manifestation of chronic renocardiac syndrome: A case report

## TL;DR

A patient with chronic kidney disease and heart failure showed a rare heart rhythm that improved after hemodialysis, suggesting a link between kidney function and heart rhythm.

## Contribution

This case report highlights AIVR as a manifestation of chronic renocardiac syndrome and its resolution through hemodialysis.

## Key findings

- The patient's AIVR resolved after starting hemodialysis.
- Uremic toxin accumulation may trigger AIVR in chronic kidney disease.
- Clearance of small solutes via hemodialysis may restore normal heart rhythm.

## Abstract

In this case report, we describe a patient who presented with chronic symptoms and signs of uremia and persistent accelerated idioventricular rhythm (AIVR) on electrocardiogram. Findings from blood tests, echocardiography, renal ultrasound, and renal scan were suggestive of heart failure with reduced ejection fraction and chronic kidney disease, and attendance of daily hemodialysis sessions led to the restoration of sinus rhythm. Typically, AIVR has a favorable prognosis and, if necessary, medical intervention focuses on addressing the underlying responsible causes. Accumulation of uremic toxins has the potential to trigger the formation of AIVR and clearance of small solutes through conventional hemodialysis may contribute to sinus rhythm restoration.

Accelerated idioventricular rhythm in a non‐dialysis patient with advanced chronic kidney disease terminated by hemodialysis.