EMS ECGs: accelerated idioventricular rhythm (AIVR) in patients with ACS and other critical cases to help you save lives!

Baltimore City EMS Cases with Dr. Amal Mattu


 A 69-year-old man is brought in by EMS to the ED with chest pain and shortness of breath. No prehospital treatment was rendered. The following prehospital ECG was obtained:

Before watching this week’s video, ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is the definition of an accelerated idioventricular rhythm (AIVR)?
  3. Is it possible to have AIVR without treatment with thrombolytics?
  4. How would you manage this rhythm?