Electrocardiographic artifacts in clinical practice: A logical approach to recognition and prevention

Figure 8 Environmental and device-related artifacts. A: Electromagnetic interference causes sharp deflections, mimicking monomorphic ventricular tachycardia; B: Holter strip showing pseudopacing artifacts that cannot be explained by any device algorithm; C: Electrocardiogram in a patient with a dual-chamber pacemaker showing pseudopacing artifacts (arrows); D: Deep brain stimulators causing high-frequency (usually 60-200 Hz) artifacts (12 pulses in 200 microseconds = 60 Hz) (arrow - zoomed snippet of V2); E: During intravascular lithotripsy, shock pulses can be detected via electrocardiogram. It can even capture the ventricles, which are called shocktopics (arrows). For each cycle of intravascular lithotripsy shock, there are 10 pulses at 1-second intervals (1 Hz).