A patient with a rhythmic limb movement may have an ECG tracing that may be misinterpreted as atrial flutter or atrioventricular block.
Rhythmic patient movements may include:
(1) Parkinson's disease
(2) other tremor
(3) shivering
(4) seizure
(5) muscle spasm
(6) nervous shaking
The diagnostic sequence is:
(1) identification of the abnormal ECG
(2) recognition of the abnormal patient movement, matching frequency of movement with the frequency of the abnormal wave in the ECG
(3) disappearance of the ECG abnormality with control of the abnormal movement
