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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Holter: Artefact Mime of VT
Report:Sinus rhythm VEBs, multiform, one dimorphic couplet (bottom panel) Movement artefact 295/min, uncertain origin Comment:The ârunâ in the top panel has an unlikely fast rate of almost 300/min, but it looks scary, especially in a patient fitted
Electromechanical Association
Report: Probable multifocal atrial tachycardia (MAT) 122/min Vertical heart position Nonspecific T wave changes Movement artefact V2-3 Comment: The earliest ECG sign of emphysema is the shift of P wave axis in the limb leads to beyond +70o. This is
Complete Chest Lead Reversal
Report:Atrial pacemaker rhythm 78/min Complete chest lead reversal Possible left ventricular hypertrophy Comment:This is a rare variant of lead reversal. It happens when the entire block of V-lead terminals is rotated 180o and inserted into the machine
Arms-Legs Reversal
Report:Sinus rhythm 60/min Legs-arms reversal Normal trace Comment:The pattern is diagnostic: retrograde P waves and flat L1. This is much less common than arms or V1 â V2 or V3 reversal. In this case the computer went for the arms reversal with âa
Two Movement Artefacts
Report:Sinus rhythm 81/min Nonspecific ST/T changes Movement artefact Comment:The wobbly crinkled baseline in the first set of leads is due to movement but does not deserve a mention because it does not distort the trace much. In V6, however, there is
Torsade Artefact
Report:Sinus rhythm 82 â 88/min VEBs, one couplet Movement artefact lower panel Comment:For some reason, the (signed) report included â1 episode of torsadesâ (Fig 90a). This is a gross error, given that normal QRS complexes can be mapped out thro
Holter Tape Stretch
Report:Sinus rhythm 68 â 70/min Paper speed or stretch artefact Comment:Variable, in this case fast, paper speed prolongs all the formed elements of the cardiogram to make them look like the last four complexes in this recording. The prolongation is i
RBBB With a Difference
Report:Sinus bradycardia Borderline right axis deviation +90o Right bundle branch block V1 â V3 reversed Comment:The RBBB looks strikingly atypical in Lead V1, until one realises that V1 and V3 had been reversed! (Looking at the T wave helps).The tr
Two Rhythms of Indubitably Ventricular Origin
Report: Pacemaker rhythm VEBs Ventricular fibrillation CPR artefact (end of bottom strip) Comment: It has been said (the actual reference eludes me) that the only two rhythms of electrocardiographically certain ventricular origin are ventricular fib
Movement Artefact
ReportSinus tachycardia 141/min Borderline left atrial abnormality (LAA) Counterclockwise rotation (early transition) Non-specific ST/T changes Movement artefact in standard leads CommentThe artefact in Lead 1 mimics a dimorphic couplet of VEBs, and