It is important to differentiate these, as misdiagnosis can lead to inadvertent use of medications and procedures in such a patient. Sometimes, EKG changes may mimic specific arrhythmias like ventricular tachycardia and atrial flutter or fibrillation. These changes can be misinterpreted as myocardial ischemia or infarction.ĭifferentiating an Artifact from Ventricular tachycardia If ST segments are affected by artifacts, either ST segment depression or elevation can occur on the EKG. It is important to differentiate these artifactual changes from genuine changes to prevent misdiagnosis. Most of the time, they are easily identifiable and neglected as they do not resemble any specific pattern.
The table includes data from references IdentificationĪrtifacts can distort individual or all components (P, QRS, T waves and PR and ST segments) on the EKG. Spikes, runaway pacemaker, ventricular fibrillation, non-specific Transcutaneous electrical nerve stimulator Ventricular tachycardia, ventricular fibrillation, non-specific Somatosensory evoked potential monitoring unitsĪtrial flutter, atrial fibrillation, ventricular tachycardia Pseudowaves (P), premature atrial contraction Straight shot microdebrider (nasal endoscopy) Medical equipment related EKG artifacts Type of equipmentĪtrial or ventricular extrasystoles, pseudowaves (QRS)ĬOBE Prisma System for continuous venovenous hemofiltration Medical equipments: In operation theatres and intensive care unit various equipments can affect EKG monitoring system (e.g.Power line electrical disturbances/ Light fixtures.deep brain stimulator) in the body and includes the following : These are non-physiological causes associated with other electrical devices attached to or implanted (e.g. Muscular activity: Allows electronic filtration (small spikes).
Simple movements such as brushing and combing the hair can produce EKG disturbances during ambulatory EKG monitoring.Tremors and shivering cause motion artifacts.Patient's motion: Does not allow electronic filtration (large swings, usually by epidermal stretching).These are physiological causes that could be due to: In this chapter, we will present the common causes and ways to characterize EKG artifacts.ĮKG artifacts can be generated by internal and external causes. It is very important to recognize these artifacts, otherwise they can lead to unnecessary testing and therapeutic interventions.
As a result of artifacts, normal components of the EKG can be distorted. 3.2.1 REVERSE mnemonic: Approach to EKG artifacts Įlectrocardiograph (EKG) artifacts are defined as EKG abnormalities, which are a measurement of cardiac potentials on the body surface and are not related to electrical activity of the heart.3.1 Differentiating an Artifact from Ventricular tachycardia.2.2.1 Medical equipment related EKG artifacts.Santosh Patel M.D., FRCA Associate Editor-In-Chief: Kashish Goel, M.D. Risk calculators and risk factors for EKG artifactsĮditor-in-Chief: C. US National Guidelines Clearinghouse on EKG artifactsĭirections to Hospitals Treating EKG artifacts Ongoing Trials on EKG artifacts at Clinical Ĭlinical Trials on EKG artifacts at Google Articles on EKG artifacts in N Eng J Med, Lancet, BMJ
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