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The Artefact and Atrial Fibrillation: An Unholy Alliance

By Assoc Prof Harry Mond
/
December 19, 2019

The most common error in ECG reporting we encounter is differentiating between sinus rhythm and atrial fibrillation particularly in poor quality tracings. Thankfully a confirmed report with this error is very rare. This is because the Techs putting the final stamp of approval on your reports are taught that:

“Atrial fibrillation with a regular ventricular response is actually sinus rhythm until proven otherwise.”
— DR HARRY MOND

Such was the case with the accompanying ECG.

An ECG of suspected atrial fibrillation, however, it needs more analysis. This data was produced using a CardioScan myPatch Holter Monitor Device, in conjunction with Holter Monitoring Software as part of a Holter Monitor Test
Our clever tech changed the rhythm strip and the diagnosis became obvious.

This ECG was produced using a CardioScan myPatch Holter Monitor Device, and read using Holter Monitoring Software as part of a Holter Monitor Test, which is included in CardioScan's Cardiac Monitoring Service

Sinus rhythm with first degree AV block.

We probably see at least one example each day.

Some examples:

This should be repeated but sometimes this is difficult to do.

This ECG was produced using a CardioScan myPatch Holter Monitor Device, and read using Holter Monitoring Software as part of a Holter Monitor Test, which is included in CardioScan's Cardiac Monitoring Service

The major footprint is QRS regularity.

The minor are the P waves.

However, this can sometimes fool you when there are atrial ectopics!!

Assoc Prof Harry Mond

About Assoc Prof Harry Mond

In 49+ years as a practicing cardiologist, Dr Harry Mond has published 260+ published manuscripts & books. A co-founder of CardioScan, he remains Medical Director and oversees 500K+ heart studies each year.

Download his full profile here.

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