Equipment-related Electrocardiographic Artifacts

Patel, Santosh; Souter, Michael J.

doi:10.1097/01.anes.0000296537.62905.25

Cited by 79 publications

(31 citation statements)

References 50 publications

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“…An improved understanding of the artifacts generated by equipment and their identifying characteristics is important to avoid misinterpretation, misdiagnosis and iatrogenic complications. [9] Our case is similar to the one reported by Gaiser et al . and alerts the clinicians, in particular anesthesiologists, to have proper understanding of the electrocardiographic artifacts during various surgical procedures.…”

Section: Discussionsupporting

confidence: 91%

Ventricular tachycardia during microdebrider-assisted turbinectomy: An electrocardiographic artifact

Sofi¹,

Khalid²,

Gilani³

2010

Saudi J Anaesth

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Interference of monitored electrocardiogram is common during different surgical procedures using electrical equipment. The electrical devices used induce artifacts in the electrocardiographic tracing, which may resemble serious arrhythmia. We describe a case of electrocardiographic artifact resembling ventricular tachycardia with the use of a Storz unidrive microdebrider during inferior turbinectomy under general anesthesia. This case report highlights the importance of knowledge of various equipment-related electrocardiographic artifacts in avoiding unnecessary and harmful therapeutic interventions.

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Section: Discussionsupporting

confidence: 91%

Ventricular tachycardia during microdebrider-assisted turbinectomy: An electrocardiographic artifact

Sofi¹,

Khalid²,

Gilani³

2010

Saudi J Anaesth

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“…444 Conduc tivity of the signal can be enhanced by proper skin preparation before electrocardiographic electrodes are placed. 444,445 The purpose of skin preparation is to cleanse the area to optimize signal transfer. Research, 446 QI projects, 435,437 and expert opinion 445,447 have identified proper skin preparation before electrocardiographic electrode ap plication to optimize conductivity.…”

Section: Skin Preparationmentioning

confidence: 99%

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

207

214

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Background and Purpose: This scientific statement provides an interprofessional, comprehensive review of evidence and recommendations for indications, duration, and implementation of continuous electro cardiographic monitoring of hospitalized patients. Since the original practice standards were published in 2004, new issues have emerged that need to be addressed: overuse of arrhythmia monitoring among a variety of patient populations, appropriate use of ischemia and QT-interval monitoring among select populations, alarm management, and documentation in electronic health records. Methods: Authors were commissioned by the American Heart Association and included experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology, as well as a hospitalist and experts in alarm management. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Authors were assigned topics relevant to their areas of expertise, reviewed the literature with an emphasis on publications since the prior practice standards, and drafted recommendations on indications and duration for electrocardiographic monitoring in accordance with the American Heart Association Level of Evidence grading algorithm that was in place at the time of commissioning. Results: The comprehensive document is grouped into 5 sections: (1) Overview of Arrhythmia, Ischemia, and QTc Monitoring; (2) Recommendations for Indication and Duration of Electrocardiographic Monitoring presented by patient population; (3) Organizational Aspects: Alarm Management, Education of Staff, and Documentation; (4) Implementation of Practice Standards; and (5) Call for Research. Conclusions: Many of the recommendations are based on limited data, so authors conclude with specific questions for further research.

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“…13 Second, no evidence of arrhythmia in plethysmographic waveform or direct arterial pressure trace can exclude the presence of actual arrhythmia. Third, the temporal association of appearance of the artefact with usage of monitoring device and disappearance with its removal points to the presence of an artefact 14. Fourth presence of synchronous and visible notching consistent with underlying ventricular rhythm through the pseudoarrhythmia favours the presence of an artefact over true arrhythmia 15…”

Section: Discussionmentioning

confidence: 98%

ECG artefacts mimicking atrial flutter in posterior fossa surgery

Rudigwa

Elakkumanan

et al. 2015

BMJ Case Reports

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ECG artefacts are defined as abnormalities in the monitored ECG, which result from measurement of cardiac potentials on the body surface and are not related to the electrical activity of the heart. In the operation theatre, the use of various types of electrical equipment may interfere with ECG interpretation. We describe our experience with artefacts resembling atrial fibrillation when a nerve integrity monitoring device was used on a patient undergoing posterior fossa surgery for epidermoid tumour. These artefacts resemble serious arrhythmias and may result in unwanted interventions. To enable better identification of such artefacts, a 12-lead ECG should be considered as it will display rhythm in all the leads; while artefacts will present in only a few leads, true arrhythmia will be present in all the 12 leads. Our case report aims to increase awareness regarding ECG artefacts and to explain how to distinguish them from actual arrhythmias.

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Equipment-related Electrocardiographic Artifacts

Cited by 79 publications

References 50 publications

Ventricular tachycardia during microdebrider-assisted turbinectomy: An electrocardiographic artifact

Ventricular tachycardia during microdebrider-assisted turbinectomy: An electrocardiographic artifact

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

ECG artefacts mimicking atrial flutter in posterior fossa surgery

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