Main artifacts in electrocardiography

Abstract

Electrocardiographic artifacts are defined as electrocardiographic alterations, not related to cardiac electrical activity. As a result of artifacts, the components of the electrocardiogram (ECG) such as the baseline and waves can be distorted. Motion artifacts are due to shaking with rhythmic movement. Examples of motion artifacts include tremors with no evident cause, Parkinson's disease, cerebellar or intention tremor, anxiety, hyperthyroidism, multiple sclerosis, and drugs such as amphetamines, xanthines, lithium, benzodiazepines, or shivering (due to hypothermia, fever (rigor due to shaking), cardiopulmonary resuscitation by chest compression (oscillations of great amplitude) and patients who move their limbs during the test, causing sudden irregularities in the ECG baseline that may resemble premature contractions or interfere with ECG wave shapes, or other supraventricular and ventricular arrhythmias. When the skeletal muscles experience shaking, the ECG is "bombarded" by apparently random electrical activity.

Can Wearable Devices Accurately Measure Heart Rate Variability? A Systematic Review

“…For example, patients with tremor or elderly patients with fragile skin have bad quality of recordings with a lot of noise and artifacts. 34 Similarly, other factors such as surface electromyography, increased electrode impedance, respiration induced baseline drift, and electrode contact movement can cause noise and motion artifacts. 7 Additionally, morphological variations in the ECG waveform and heterogeneity in the QRS complex can often make diffi cult to identify the RR interval.…”

Photoplethysmography behind the Ear Outperforms Electrocardiogram for Cardiovascular Monitoring in Dynamic Environments

“…This is due to a number of electrophysiological factors and highlights the general unacceptability of using ECG in environments of movement, especially tactical aircraft. ECG has been found to be highly unreliable and mostly unusable during periods of motion [ 16 ]. Also problematic, ECG technology captures data through electrodes, which are too cumbersome and distracting to wear while working, especially in a high-stakes environment such as flight, defense, or first response.…”

“…Motion artifacts in ECG can include external and internal interference caused by numerous factors such as shaking with rhythmic movement, poor grounding of the device, interference by other devices in the vicinity such as electrical beds, surgical and fluorescent lamps, artifacts produced by alternating current affecting the ECG baseline, mistaken placement in the cable junction box, muscle twitching, inappropriate cleansing of the skin, excess of precordial conductive gel, and mistaken placement of both limb and precordial leads, all can all cause irregularities in an ECG baseline. as [ 16 ]. As a result of any or a combination of these potential artifacts, the components of the electrocardiogram (ECG) such as the baseline and waves are distorted, as seen in this study.…”

“…Most of today’s commercial physiological monitoring wearable devices employ photoplethysmography (PPG) sensors which detect and analyze differential transmissivity of near-infrared light to calculate SpO2 and PR, Electrocardiogram (ECG) has been the gold standard of Heart Rate (HR) measurement, but it is primarily used and most effective in non-motion environments (e.g., lying still) [ 15 ]. ECG has been found to be highly unreliable and mostly unusable during periods of motion [ 16 ]. This is due to several factors and highlights the general unacceptability of using ECG in extreme operational environments.…”

Real-Time Webcam Heart-Rate and Variability Estimation with Clean Ground Truth for Evaluation

“…Another significant but overlooked complication with existing rPPG datasets arises from their provided ground truth signals, typically photoplethysmogram (PPG) or electrocardiogram (ECG) waveform. These signals are often plagued by artefacts, for example in the form of large spikes caused by unwanted sensor movement and interference [1,14]. This causes false peak detections resulting in incorrect ground truth HR and HRV measures, thereby leading to unreliable evaluation.…”