Letters to the Editor
Case Report: Differentiating Artifact from True Ventricular Tachycardia
Am Fam Physician. 2006 Sep 15;74(6):921.
to the editor: A healthy 43-year-old man underwent Holter monitoring to evaluate palpitations. Electrocardiograms obtained at rest and after three minutes of step-test were normal, with heart rates of 58 and 102 beats per minute, respectively. Physical examination was unremarkable. The Holter monitor (see accompanying figure) showed an underlying sinus rhythm interrupted briefly by what appears to be wide-complex tachycardia. However, within the “ventricular tachycardia,” QRS complexes were visible at intervals that coincided with the cycle length of the baseline rhythm. The rest of the Holter monitoring was normal. When asked what he had been doing during the event, the patient denied symptoms and explained that he had been brushing his teeth. Repeated Holter monitoring and an echocardiogram were unremarkable.
This case demonstrates characteristics that may be helpful in differentiating artifact from true ventricular tachycardia: the absence of symptoms during the event, normal QRS complexes within the arrhythmia, and an association with body movement.1
1. Lin SL, Wang SP, Kong CW, Chang MS. Artifact simulating ventricular and atrial arrhythmia. Jpn Heart J. 1991;32:847–51.
Send letters to firstname.lastname@example.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680. Include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.
Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the AAFP permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.
This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.
Copyright © 2006 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact email@example.com for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions