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Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia
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Table of Contents
LETTER TO EDITOR  
Year : 2012  |  Volume : 15  |  Issue : 1  |  Page : 85-86
Artifactual electrocardiographic ST segment depression: Less likely due to electrocautery


Department of Anaesthesia, Rochdale Infirmary, Rochdale OL12 0NB, United Kingdom

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Date of Web Publication5-Jan-2012
 

How to cite this article:
Patel S. Artifactual electrocardiographic ST segment depression: Less likely due to electrocautery. Ann Card Anaesth 2012;15:85-6

How to cite this URL:
Patel S. Artifactual electrocardiographic ST segment depression: Less likely due to electrocautery. Ann Card Anaesth [serial online] 2012 [cited 2019 Jul 21];15:85-6. Available from: http://www.annals.in/text.asp?2012/15/1/85/91469


The Editor,

I read with interest the letter by Jain et al. [1] describing ST segment artifact during routine electrocardiograph (ECG) monitoring. However, the authors have not reported the following details: Manufacturer of the machine, degree of ST segment depression, whether monitor or diagnostic mode was used, and automated or manual ST segment monitoring was displayed. The extent of signal distortion may differ in different ECG systems. [2] Sensitivity and specificity of diagnostic ST segment changes for myocardial ischemia varies among manufactures of ECG machines. ST depression of 0.5 mm is well within the margin of error. In addition, lead placement and position in relation to cautery pad position and placement are also important to know.

The author's explanation of the mechanism of artifact is unlikely. Electrocautery is a high frequency signal. If at all there is an interaction between a genuine cardiac signal and an electrocautery signal, the most likely scenario would be loss of cardiac signal. The ST segment depression, as shown in ECG by the authors, is more likely due to procession of ECG signal by monitor. The filters within the monitor depending on their cutoff frequency can distort ST segment. "Monitor" mode is more likely to corrupt ST segment, which is a low frequency signal.

I agree with the authors that ECG artifacts should be considered when changes are intermittent and coinciding with the use of specific equipment. [3]

 
   References Top

1.Jain A, Solanki SL, Sahni N, Sharma A. Artifactual ST segment depression induced by electrocautery. Ann Card Anaesth 2011;14:164-5.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Yang H. Intraoperative automated ST segment analysis: A reliable 'black box'? Can J Anesthe 1996;43:1041-51.  Back to cited text no. 2
    
3.Patel SI, Souter MJ. Equipment-related electrocardiographic artifacts: Causes, characteristics, consequences, and correction. Anesthesiology 2008;108:138-48.  Back to cited text no. 3
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Correspondence Address:
Santosh Patel
Department of Anaesthesia, The Royal Oldham Hospital, Oldham, OL1 2JH
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.91469

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