This 57-year-old man with severe unstable angina was taken to the operating room for urgent revascularization. He had four aorto-coronary bypasses and an endarterectomy of the right coronary artery. This ECG was recorded 30 minutes after transfer from the operating room to the cardiac surgical intensive care unit:

• Sinus rhythm with AV dissociation due to an accelerated idioventricular rhythm
• Ventricular rate 83/min
• T wave abnormality, consider inferior ischemia

The clinical condition of the patient is stable and satisfactory. The following ECG is recorded 14 hours later:

• Sinus rhythm, 79/min
• T wave abnormality, consider inferior ischemia

The accelerated idioventricular rhythm documented in the first ECG was an example of reperfusion arrhythmia, following a successful surgical revascularization procedure.