title: Electrocardiographic artefacts mimicking atrial tachycardia resulted in unnecessary diagnostic and therapeutic measures.
abstract: Electrocardiographic (ECG) artefacts may closely simulate both supraventricular and ventricular tachycardias. We describe a case initially diagnosed as rapid atrial fibrillation, based on 12-lead surface ECG (especially the limb leads) and monitor tracing. The arrhythmia was resistant to beta blockers. Because of the at times apparently regular rhythm, an esophageal ECG recording was performed, and adenosine was administered. When the presumed atrial fibrillation terminated after sodium pentothal was administered while preparing for electrical cardioversion, the oesophageal ECG recordings and the ECGs during adenosine administration were reviewed. An ECG artefact diagnosis was suspected, and then confirmed, during relapse of the "arrhythmia," with simple palpation of the radial pulse and cardiac auscultation.
authors.affiliation: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. shams.younis-hassan@ karolinska.se
authors.forename: Shams
authors.initials: S
authors.lastname: Y-Hassan
authors.forename: Christer
authors.initials: C
authors.lastname: Sylvén
mesh_terms: D000241:Adenosine; D000328:Adult; D016477:Artifacts; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D003951:Diagnostic Errors; D004562:Electrocardiography; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors; D019564:Unnecessary Procedures
chemical_list: D000241:Adenosine
keywords: Arrhythmias, cardiac; Artefact; Atrial fibrillation; Electrocardiography; Tachycardia, supraventricular