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Related Experiment Videos

Pseudo atrial flutter.

Conor D Barrett1, Peter J Kelly, Carmel Halley

  • 1Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.

European Journal of Internal Medicine
|December 7, 2007
PubMed
Summary
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Parkinsonian tremor mimicking atrial flutter on ECG can be misdiagnosed. A 12-lead ECG confirmed normal sinus rhythm, preventing unnecessary treatment for this cardiac arrhythmia.

Area of Science:

  • Cardiology
  • Neurology

Background:

  • Atrial flutter commonly presents with a cycle length of 200 ms, leading to specific ventricular rates with AV node conduction.
  • Misinterpretation of electrocardiogram (ECG) findings can lead to inappropriate patient management.

Purpose of the Study:

  • To report a case where Parkinsonian tremor mimicked atrial flutter on a 12-lead ECG.
  • To highlight the importance of comprehensive ECG assessment in differentiating arrhythmias from other physiological signals.

Main Methods:

  • Case report presentation.
  • Analysis of a 12-lead ECG and rhythm strips.
  • Clinical correlation of patient symptoms and ECG findings.

Main Results:

  • A patient's Parkinsonian tremor at 300 cycles/min was initially mistaken for atrial flutter on limb leads and a rhythm strip.

Related Experiment Videos

  • The patient's coincident intrinsic sinus rate of 75 bpm further contributed to the diagnostic confusion.
  • A subsequent 12-lead ECG revealed normal sinus rhythm, ruling out atrial flutter.

    • Conclusions:

    • Parkinsonian tremor can present as an atrial flutter mimic on ECG, necessitating careful evaluation.
    • Accurate ECG interpretation is crucial to avoid unnecessary anticoagulation and cardioversion for non-existent arrhythmias.
    • Distinguishing between tremor artifacts and true cardiac arrhythmias ensures appropriate patient care and avoids iatrogenic complications.