Key result
Exchanging cardiac monitor leads completely resolves fixed frequency square wave ECG artifacts.
Why the study?
Electrocardiogram artifacts are common and can lead to diagnostic errors and unnecessary workup if not properly recognized and troubleshooted.
Case Report (n=1)
Faulty external cardiac monitor leads can cause a fixed frequency square wave artifact on an ECG, highlighting the importance of troubleshooting when ECG findings do not match clinical presentation.
Answers are grounded in this paper and cite their sources.
Supports troubleshooting leads for unexplained ECG artifacts; this case report leaves open their prevalence and generalizability.
CASE PRESENTATION: We present the case of a 74-year-old female patient who presented to the emergency department with lower extremity weakness found to have a fixed frequency square wave artifact in all leads of her electrocardiogram (ECG). After troubleshooting, faulty external cardiac monitor leads were identified as the cause of this unique artifact. DISCUSSION: The ECG is an important diagnostic tool for medical providers. Electrocardiogram artifacts are extremely common, and knowledge of artifacts is necessary to prevent inappropriate interpretation, diagnostic error, and unnecessary workup. Medical providers should have a low threshold for suspicion when ECG findings do not correlate with the patient's chief complaint or history of present illness. They must also be familiar with the most frequent ECG artifact variants and be prepared to follow a stepwise approach to troubleshoot less frequent variants.
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Imhoff et al. (2021) conducted a case report in ECG artifact (n=1). Exchanging cardiac monitor leads vs. Faulty cardiac monitor leads was evaluated on Resolution of ECG artifact. Exchanging the room's cardiac monitor leads resulted in complete resolution of a fixed frequency square wave ECG artifact.
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