Muscle fasciculation detected by ECG

Area of Science:

• Cardiology
• Neurology
• Medical Diagnostics

Background:

• A 79-year-old male experienced syncope and scald burns from a hot bathtub.
• Electrocardiogram (ECG) interpretation is critical for diagnosing cardiac events.

Observation:

• Admission ECG showed high-frequency irregular waveforms (over 1000 cycles/min) in lead V2.
• These waveforms were initially misdiagnosed as possible ventricular fibrillation.
• Follow-up ECG revealed complete resolution of the irregular waveforms.

Findings:

• The irregular waveforms were identified as ECG artifact caused by skeletal muscle contractions (fasciculations).
• Muscle fasciculations can mimic serious cardiac arrhythmias like ventricular fibrillation.
• In this case, the fasciculations were benign and unrelated to a cardiac event.

Implications:

• This case underscores the importance of recognizing muscle fasciculations as a common, benign cause of ECG artifact.
• Accurate differentiation between artifact and true arrhythmia is crucial for appropriate patient management.
• Prompt diagnosis prevented unnecessary cardiac interventions and guided appropriate treatment for the patient's burns.