title: Piezoelectric electrocardiographic artifact in a patient after surgery with bradycardia and hypotension.
abstract: A 64-year-old man was evaluated by a rapid response team for altered mental status shortly after an uncomplicated surgery. He was found to be hypotensive and bradycardic, and an emergent electrocardiogram showed extra "P" wave complexes, ultimately found to be piezoelectric artifacts from a fluid infusion pump. Equipment-related artifacts have been known to mimic arrhythmias prompting unnecessary therapeutic interventions including antiarrhythmics and direct current shocks. Timely recognition of the unusual properties of the complexes resulted in the avoidance of atropine, epinephrine, or transcutaneous pacing in a rapid response team scenario.
authors.affiliation: Cedars-Sinai Heart Institute, Los Angeles, CA.
authors.forename: Richard
authors.initials: R
authors.lastname: Cheng
authors.forename: Tarun
authors.initials: T
authors.lastname: Chakravarty
mesh_terms: D001145:Arrhythmias, Cardiac; D016477:Artifacts; D001919:Bradycardia / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D007022:Hypotension / Q000150:complications* / Q000175:diagnosis; D007260:Infusion Pumps; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*
keywords: bradycardia; equipment-related ECG artifact; piezoelectric