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Challenges in Clinical Electrocardiography
March 2014

Uncommon Etiology of Abnormal Spikes on Electrocardiogram

Author Affiliations
  • 1Department of Cardiology, Städtisches Klinikum München–Bogenhausen, Munich, Germany
  • 2Department of Gastroenterology and Hepatology and Gastrointestinal Oncology, Städtisches Klinikum München–Bogenhausen, Munich, Germany

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JAMA Intern Med. 2014;174(3):458-459. doi:10.1001/jamainternmed.2013.13666

A 75-year-old woman was referred to our pacemaker/implantable cardioverter-defibrillator (ICD) clinic with an abnormal electrocardiogram (ECG). The ECG (Figure, A) showed abnormal spikes compared with a regular ECG (without spikes) (Figure, B) of the same patient performed 3 months earlier, prompting a referral for device interrogation. Clinical manifestations such as dizziness, lightheadedness, syncope, or signs and symptoms of congestive heart failure were absent. The patient’s vital signs were normal.

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