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 (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