ECG artefacts mimicking atrial flutter in posterior fossa surgery

Abstract

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.

A Rare Case of Pseudo-atrial Flutter Waves in a Patient with Essential Tremor

“…Muscle tremor, hiccups, and medical electrostimulation devices are some of the most common causes of ECG artifacts that can mimic supraventricular tachycardias, including atrial flutter [ 1 , 4 ]. However, in most cases, pseudo-flutter waves are primarily detected in limb leads.…”

Sequential events of asystole and cranial nerve monitor induced narrow QRS complex ECG artefacts: An uncommon combination during a common neurosurgery

“…[ 1 4 ] Only a single report mentions about atypical atrial flutter as an ECG artefact from the cranial nerve monitor (rectified following removal of the stimulator probe from the chest drape). [ 5 ]…”