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However, accurate recognition of artifacts on the electrocardiogram is generally poor among physicians. Misdiagnosis of artifact may subject patients to unnecessary diagnostic and therapeutic interventions for arrhythmia. A review of six major clinical cardiology and electrocardiography textbooks do not discuss the topic, and although electrocardiographic artifacts have been previously reviewed to some degree, a detailed and contemporary review of equipment-related artifacts is still lacking. The purpose of this article is to discuss the causes, characteristics, consequences, and correction of equipment-related artifacts on the monitored or recorded electrocardiographic tracing in the modern clinical setting.
Origin and Measurement of the Electrocardiographic Waveform
Because of varying tissue resistances from heart to skin, attenuated body surface potentials have an amplitude of only 1% of the amplitude of transmembrane potentials (0.5 to 2.0 mV) across cardiac cells. Voltage of several millivolts can be generated by physically stretching the epidermis. The surface electrodes convert an ionic current into a flow of electrons. Disposable electrodes develop ionic potentials at the electrode–electrolyte interface known as half-cell potentials.
Equipment or Its Component-related Electrocardiographic Artifacts:
- Hemodialysis machine
- Evoked potentials monitoring unit
- Electrostimulators
- Thalamic spinal cord,
- Other electrostimulators
- Cardiopulmonary bypass
- Ventilator—HFOV
- Intravenous fluid warmer/warming set
- Flexible bronchoscope
- Digital urine output/core temperature monitor
- Pressure-controlled irrigation pump
- Cell phone
- Sinus endoscope
- Intraoperative Orthopedic shaver
- Monitor and its components Manufacturing problem (50/60-Hz filter)
- Defective monitor insulation
