ECG Quest > Basics > Artefact > Wandering baseline

Wandering baseline

The baseline of the ECG should be flat. Sometimes the baseline will instead wander upwards and downwards, which can make it difficult to interpret the ECG. This Wandering Baseline can be caused by poor electrode contact or pronounced respirations.

See also: Artefact

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In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Regular Tachycardia Wandering baseline Excessive discordant ST depression. Excessive discordant ST elevation Pacemaker spikes Wide QRS Ventricular pacemaker Multi-vessel disease 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Can you see through this wide complex rhythm?

This ECG is from a man in his 70s who presented with intermittent dyspnoea and chest pain over the past 2 weeks. He had a history of a pacemaker, heart failure, aortic stenosis, diabetes, hypertension, stroke, ischemic heart disease, chronic kidney disease and peripheral vascular disease. This was his initial ECG.

This ECG shows a wide complex tachycardia with ventricular pacing. The excessively discordant ST changes in V4-6 and aVR suggested diffuse subendocardial ischemia. He was found to have severe three vessel disease and a proximal left circumflex stenosis was stented.

In the ECGquest archives, this ECG has been tagged with: - Bradycardia Wandering baseline Extra P waves Third degree AV block 12-Lead ECG of the Week CC-BY-NC-SA
ECG of the Week – 12th November 2018 – Interpretation

This ECG is from a woman in her 70s who presented following a fall at home.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Wandering baseline Anterior ST depression Lateral ST elevation 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer Dr Stephen W. Smith CC BY-NC
Posterolateral OMI resulting in VT, then R-on-T phenomenon and VF

This ECG is from a man in his 50s who presented with 1 hour of chest pain and shortness of breath. This was his triage ECG.

In the ECGquest archives, this ECG has been tagged with: - Tachycardia Wandering baseline Sinus tachycardia Hyperkalemia 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog CC BY-NC
Could you have prevented this young man’s cardiac arrest? Baseline ECG

This ECG is from a young man who was found at the bottom of his basement stairs. He complained of right hip or leg pain but seemed confused about what had happened. He had a history of IV heroin abuse. Shortly after he had a wide complex PEA arrest and had a ROSC after 20 min of resuscitation with epinephrine, glucose, calcium and bicarb. This was his baseline ECG from a previous presentation.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Wandering baseline Excessive discordant ST elevation Pacemaker spikes Wide QRS Ventricular pacemaker Acute Inferior MI 12-Lead Serial 12-lead Dr Smith's ECG Blog CC BY-NC
A 50-something with h/o coronary bypass has chest pain and a ventricular paced rhythm – 2, in ED

This ECG is from a man in his 50s who presented with chest pain on a background of previous CABG and dual chamber pacemaker. This was the repeat ECG on arrival.

This ECG shows a wandering baseline making ST interpretation difficult, but a ventricular paced rhythm with excessive discordant ST depression in aVL and borderline excessive discordant ST elevation in inferior leads. The cause was an inferior and right ventricular infarction.