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March 19, 1982

Electrocardiographic Artifacts Caused by Defective Marker Circuitry

JAMA. 1982;247(11):1564-1565. doi:10.1001/jama.1982.03320360016012

To the Editor.—  Interpretation of ECG is complicated by a variety of artifacts caused by disturbances such as broken lead wires (1972;220:1130; 1973;223:439) and transposed lead wires (1979;242:617), muscle tremors, seizures and hiccups,1,2 arteriovenous fistula (1979;241:2380), intravenous infusion devices,3,4 malfunction of an electric watch (1974;228:26), and a pacemaker pulse-width controller.5 Reported here is an artifact resembling an intermittent atrial flutter caused by defective marker circuitry of an ECG machine.

Report of a Case.—  A 48-year-old man experienced the onset of chest pain while playing tennis and was brought to the emergency room of the Maui Memorial Hospital. An ECG was obtained, and the physician on duty reviewed the strip before mounting the lead samples onto an ECG form. Although there was no evidence of ischemia or infarction, the physician observed what appeared to be P waves in rapid irregular bursts (Figure) and arranged admission to the coronary care