#FridayImageChallenge!

Friday Image Challenge – from ECGs to X-rays to…who knows what we will find!

At the end of every week, we show you a quick image challenge selected by our wonderful Residents and Interns! Dr. Spencer Carter brings to us this week’s image.

On Monday, we reveal the answer and some details!

AIVR

ANSWER:

AIVR (accelerated interventricular rhythm)

  • Features: Wide complex (QRS >120ms), regular, no p waves, rate 50-120 ( if same rhythm and <50 called ventricular escape, >120 it’s called Ventricular Tachycardia), capture or fusion beats are often present.
  • Classically seen in reperfusion phase of acute STEMI (eg after TPA), also can be seen with digoxin toxicity, cocaine, electrolyte abnormalities, and myocarditis
  • Often is well tolerated and self-limiting
  • Pearls- treat by correcting underlying condition, anti-arrhythmics might cause precipitous hemodynamic compromise