QRS double counting by ECG software in ST elevation myocardial infarction.
1Sicherheit und Ordnung, Gefahrenabwehr, Rettungsdienst Kreis Herford, Wittekindstr. 7, 32051, Herford, Germany. Steffen.Grautoff@klinikum-herford.de.
Herzschrittmachertherapie & Elektrophysiologie
|February 6, 2023
Summary
ECG software can misinterpret ST-elevation myocardial infarction (STEMI) by double-counting QRS complexes, leading to false tachycardia alarms. This case highlights the importance of recognizing this potential misdiagnosis in STEMI patients.
Area of Science:
- Cardiology
- Medical Technology
- Electrocardiography
Background:
- ST-elevation myocardial infarction (STEMI) requires prompt diagnosis and monitoring.
- Electrocardiogram (ECG) interpretation software aids in real-time patient assessment.
- QRS complex double counting is a known ECG artifact, previously associated only with hyperkalemia.
Observation:
- A 62-year-old female patient with STEMI experienced monitor alarms for tachycardia.
- The alarm persisted despite a normal pulse rate.
- ECG software was found to be double-counting the QRS complex.
Findings:
- This is the first documented case of QRS complex double counting occurring in the context of STEMI.
- The ECG artifact mimicked tachycardia, leading to a potential misdiagnosis.
- The misinterpretation was not due to hyperkalemia, challenging previous understandings.
Implications:
- Healthcare professionals monitoring myocardial infarction patients must be vigilant for ECG software misinterpretations.
- Awareness of QRS double counting in STEMI can prevent diagnostic errors.
- This finding necessitates a review of ECG algorithm performance in acute coronary syndromes.
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