Proficiency vs Deficiency… The Art Of Electrocardiography Analysis

Conclusion to 1st case: This patient was admitted to the cardiovascular unit,  awaiting pacemaker placement.   Another example of why we should not solely rely on the computerized ECG interpretation: There is a sinus rhythm with LVH, physiologic Leftward axis (aVF is the isoelectric lead perpendicular to Lead I) at approximately -10 degrees. No primary (ischemic) ST-T changes with normal R wave progression and QT prolongation. The computerized ECG interpretation is “SINUS TACHYCARDIA WITH 2nd DEGREE AV BLOCK 2:1 AV CONDUCTION”  Does this mean that we will give Atropine or stand by pacing for the 2nd degree AVB? If you answer is NO, then you’re on the right track…   Now, in most instances, the computerized interpretation is accurate and useful:   EMS HUMOR!!!  While other times, it may not be as specific, depending on variations, most commonly movement and poor lead placement leading to Artifact:     Artifact is one of the most common causes of inaccurate Atrial Fibrillation and Atrial Flutter computerized interpretation Other causes of inaccurate computerized interpretation include: QRS width Intrinsic rate and irregularity ST segment and T wave morphology This is taking into consideration that each system has an analysis algorithm, like the Physio-Control’s Lifepak 15, one of the most common cardiac monitors used prehospitally, which uses the Glascow Analysis Algorithm, which gives us the computerized interpretations base...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: 12 lead ecg Source Type: research