An accurate electrocardiographic algorithm for differentiation of tremor-induced pseudo-ventricular tachycardia and true ventricular tachycardia

Electrocardiography Pitfalls and Artifacts: The 10 Commandments

“…With careful measuring to see where normal beats should be, they will often "jump out" at the observer and become obvious, whereas at first glance they may be completely obscured. Pseudo-ventricular tachycardia has 3 characteristic signs 8 ( Figure 3):…”

“…8,[14][15][16] Misinterpretation of tremor-induced artifact may lead to serious medical errors such as the initiation of long-term use of anticoagulants for pseudo-atrial fibrillation. 17 Figure 6 shows pseudo-atrial flutter that was a tremor-induced artifact.…”

What Is Your Diagnosis: Ventricular or Pseudo-Tachycardia?

“…We recently observed an interesting case suggesting tremorinduced pseudo-VT and used the algorithm described by Huang et al (2). In our case, 2 of 3 signs of the algorithm were present; sinus sign and notch sign.…”

“…To confirm the presence of artifact, one need only establish that the notch-to-notch intervals correspond to the sinus RR intervals, which can easily be done in each of these recordings. Huang et al (2) systematically created the accuracy of electrocardiographic algorithm for the differentiation of tremor-induced pseudo-VT from true VT. They used 3 electrocardiographic signs: ''sinus'' sign, ''spike'' sign, and ''notch'' sign, and created an electrocardiographic algorithm.…”

Artifact versus arrhythmia in pseudo-polymorphic tachycardia; case report

“…While it can sometimes be a challenge to correctly identify a patient's rhythm, Huang et al have proposed a tested ECG algorithm to differentiate tremor induced pseudo-VT and true VT. 1 According to the algorithm, the presence of any of the three characteristic signs will exclude true VT as the diagnosis. Our patient's tracing has the characteristic "sinus sign", wherein sinus rhythm is observed in a frontal or limb lead as demonstrated in leads III and V1 ( Figure 2 …”