Quality Issues and Artefact
- Rowlands, A and Sargent, A (2019) - The ECG Workbook, 4th edn, M&K Publishing
- (2015) - ECG Interpretation Made Incredibly Easy!, 6th edn, Lippincott Williams & Wilkins
- Wagner, GS and Strauss, DG (2013) - Marriott's Practical Electrocardiography, 12th edn, LWW
- Nurseledclinics (2011) - www.fastlearnecg.com : Simple reading and Interpreting of a 12-lead ECG (EKG) - Yes you can do it!, (Accessed: 10/09/2019)
Groups of Signs
- Irregular baselines:
Variations: Quality Issues and Artefact
- Standard Calibration
- Chest compression artefact
- Double speed 50 mm/sec
- Wandering baseline
- Nonspecific baseline artefact
- Electrical interference artefact
- LA/RA electrode reversal
- LA/LL electrode reversal
- RA/LL electrode reversal
- RA/RL electrode reversal
- LA/RL electrode reversal
- LA/LL + RA/RL electrode reversals
- High V1/V2 misplacement
- Electrode Detachment
- Incorrect Machine Interpretation
- Transcutaneous pacing artefact
- Fistula artifact
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.
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.
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.
Where did they come from?
These ECGs were collected from Free Open Access Medical Education (#FOAMed) blogs, with the permission of their authors. You can find out more about each ECG's source by clicking on it.
Why are they here?
This is an experiment in digital curation. The idea is to collect resources to increase awareness and accessibility. Over time, more ECGs in the collection will be tagged to make it easier to find them and reused in new interactive quizzes.
How can I use these ECGs?
You can use these ECGs for your own learning, teaching or research - as long as you abide by the terms of each ECG's copyright licence as stipulated by the original author.