Pseudo ventricular tachycardia: a case report

A 30-year-old man with past medical history of asthma presented for evaluation of nocturnal shortness of breath and daytime fatigue. His medications included an albuterol inhaler used as needed, fl uticasone-salmeterol discus inhaler used daily, and cetirizine used daily. He smoked half a pack of cigarettes each day. Physical exam revealed an obese man with a body mass index of 33. Cardiac and respiratory exam were unremarkable.A split-night polysomnogram (PSG) was performed. During the diagnostic portion of the PSG, total sleep time (TST) was 173 min, sleep onset was 3 Ventricular or Pseudo-Ventricular tachycardia on PolysomnogramRomy Hoque, M.D.; Lourdes DelRosso, M.D. Division of Sleep Medicine, Department of Neurology, Louisiana State University School of Medicine, Shreveport, LAmin, sleep effi ciency was 90%, wake after sleep onset was 16 min, TST apnea hypopnea index (AHI) was 5.9, and REM AHI was 85.7. During the titration portion of the PSG, sleep disordered breathing resolved at continuous positive airway pressure of 11 cm. PSG review revealed an electrocardiogram (ECG) fi nding shown in Figure 1A, with an enlarged view of the relevant ECG shown in Figure 1B. QuEstion:What is the signifi cance of this ECG fi nding?

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“…4 Three signs are useful in the identifying tremor/movement induced pseudo-VT on ECG: the sinus sign, the spike sign, and the notch sign.…”

Section: Discussionmentioning

confidence: 99%

Ventricular or Pseudo-Ventricular Tachycardia on Polysomnogram

Hoque

DelRosso²

2013

Journal of Clinical Sleep Medicine

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“…In a patient with a wide tachycardia complex and tremors, an artifact related to tremors should be considered (Sawhney & Campbell, 2014). A careful analysis of the ECG may exclude artifacts related to pseudo-ventricular tachycardia (Llinas & Henderson, 1999;Riaz, Gardezi, & O'Reilly, 2010). The proper interpretation of ECGs and a correlation with clinical history are keys.…”

Section: Electrocardiographic Artifacts Observed In Parkinson's Disease and Parkinsonian Syndromes (Due To Rest Tremor)mentioning

confidence: 99%

Main artifacts in electrocardiography

Pérez‐Riera

Barbosa‐Barros

Daminello‐Raimundo

et al. 2017

Noninvasive Electrocardiol

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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.

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Pseudo ventricular tachycardia: a case report

Abstract: This case highlights the importance of correlating ECG findings with history and clinical examination and of using 12 lead ECGs for rhythm interpretation especially to confirm consistence of arrhythmias in all leads.

Cited by 2 publications

References 2 publications

Ventricular or Pseudo-Ventricular Tachycardia on Polysomnogram

Ventricular or Pseudo-Ventricular Tachycardia on Polysomnogram

Main artifacts in electrocardiography

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