Sinus rhythm after artifact reduction
Two ECGs That Tell Different Stories
A 73-year-old woman with Parkinson disease has different ECG appearances depending on whether her arms are immobilized. The tracing shown was recorded after immobilization.
Look for
- Regular P waves preceding the QRS complexes.
- Consistent P–QRS relationship.
Where to look. Start in lead II for the P–QRS relationship, then check all 12 leads.
Activation begins in the sinus node and then reaches the ventricles. A tracing described as normal does not exclude heart disease.
Figure 3 shows the control after immobilization. Figures 1–2 in the same article show the misleading artifact.
References & provenance
The ECG Made Easy, 9e, ch. 2, PDF 41–44; ch. 4, PDF 91–93; Lilly, 6e, ch. 4, p. 85–88.
Global Pseudo-Atrial Flutter on Electrocardiogram and the Importance of Clinical Correlation
Ashwin Jagadish; Shobha Hiremagalur; Alexander Muacevic; John R Adler. Global Pseudo-Atrial Flutter on Electrocardiogram and the Importance of Clinical Correlation. 2023. doi:10.7759/cureus.35982. Figure 3. CC BY 4.0. CC BY 4.0
Adaptation: cropping and removal of headers/annotations outside the tracing where applicable; metadata removed. Waveforms have not been redrawn.
Compared with the published source; no independent clinical validation is claimed.
Original annotations & limitations
Rythme sinusal après suppression d’artéfacts
Femme de 73 ans atteinte de Parkinson; ECG automatique annoncé comme flutter; rythme sinusal visible lorsque les bras sont immobilisés.
Une seule patiente et un seul cas: comparer aux figures 1/2 sans compter chaque tracé comme un nouveau cas.