Key result
Intraoperative ECG artifacts mimicking VT risk inappropriate therapies without hemodynamic correlation.
Why the study?
Intraoperative ECG artifacts resembling ventricular tachycardia are often misinterpreted, leading to inappropriate therapies, and literature on anesthesia providers identifying these artifacts is scant.
Case Report (n=2)
No
Intraoperative ECG artifacts can closely mimic ventricular tachycardia, highlighting the need for careful evaluation to avoid inappropriate and potentially harmful interventions.
Supports vigilance for ECG artifacts in surgery; single case leaves open incidence and mitigation strategies.
Electrocardiographic (ECG) artifacts may resemble ventricular tachycardia (VT), leading to inappropriate therapies. Despite extensive training, electrophysiologists have still been shown to misinterpret artifacts. The literature is scant regarding the intraoperative identification by anesthesia providers of ECG artifacts resembling VT. We present two cases of the intraoperative occurrence of ECG artifacts resembling VT. The first case involved a patient undergoing extremity surgery after receiving a peripheral nerve block. The patient was treated with a lipid emulsion for a presumptive local anesthetic systemic toxicity diagnosis. The second case was a patient with an implantable cardiac defibrillator (ICD) with suspended anti-tachycardia functionality due to the location of the surgery in the region of the ICD generator. The second case's ECG was identified as an artifact, and no treatment was initiated. Misinterpretation of intraoperative ECG artifacts continues to lead clinicians to institute unnecessary therapies. Our first case occurred in the context of a peripheral nerve block leading to the misdiagnosis of local anesthetic toxicity. The second case occurred during the physical manipulation of the patient during liposuction.
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DeLeon et al. (2023) conducted a case report in Intraoperative ECG artifact mimicking ventricular tachycardia (n=2). Intraoperative ECG artifact was evaluated on Clinical response to ECG artifact. Intraoperative ECG artifacts mimicking ventricular tachycardia can lead to inappropriate therapies, highlighting the need to correlate ECG findings with hemodynamics and surgical manipulation.
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