Patel and Souter identified a number of devices that can cause artifacts in an electrocardiogram. An unexpected change in the ECG of a person exposed to one or more of these devices should prompt retesting in the absence of any interference. The authors are from Royal Lancaster Infirmary and Harborview Medical Center.


Devices or equipment that can cause artifacts in an ECG:

(1) electrical stimulator (transcutaneous nerve, spinal cord, thalamic, other)

(2) hemodialysis unit

(3) pheresis unit (plasmapheresis, leukopheresis)

(4) cardiopulmonary bypass pump

(5) mechanical ventilator

(6) intravenous fluid or blood warmer

(7) extracorporeal shock wave lithotripsy unit

(8) endoscope (bronchoscope, sinus, other)

(9) core temperature monitor

(10) pressure-controlled irrigation pump

(11) orthopedic shaver

(12) intraoperative MRI unit

(13) cell phone

(14) evoked potentials monitoring unit


Defects in the ECG display device (monitor, printer, etc):

(1) defective insulation

(2) defective 50/60 Hz filter or shielding

(3) defective grounding

(4) excessive vibration


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