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QRS double counting by ECG software in ST elevation myocardial infarction

QRS-Doppelzählung durch EKG-Software im Rahmen eines ST-Hebungs-Infarkts

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Abstract

A 62-year-old female patient suffering from ST elevation myocardial infarction (STEMI) was transported to a cardiology facility. During transport, the monitor triggered an alarm for tachycardia despite a normal pulse. The reason was a misinterpretation of the ECG software, which double counted the QRS complex. QRS double counting has been reported in the setting of hyperkalemia only. In this case report, QRS double counting in association with STEMI is documented for the first time. Healthcare workers who are monitoring patients with myocardial infarction should be aware of this misdiagnosis and able to recognize the pattern.

Zusammenfassung

Bei einer 62-jährigen Patientin mit ST-Hebungs-Infarkt (STEMI) wurde während des Transports in die Klinik im Rahmen der Monitorüberwachung ein Tachykardiealarm ausgelöst – trotz normaler Pulsfrequenz. Bei näherer Betrachtung konnte eine Fehlinterpretation durch die EKG-Software festgestellt werden, welche QRS-Komplexe doppelt zählte. Zu keinem Zeitpunkt hatte eine Tachykardie vorgelegen. Eine derartige Konstellation ist bislang nur im Rahmen einer Hyperkaliämie beschrieben worden und wird hier erstmalig in Verbindung mit einem STEMI vorgestellt. Medizinisches Personal, das an der Überwachung von Patienten mit Infarkt beteiligt ist, soll diese Fehldiagnose und das möglicherweise auftretende EKG-Muster kennen.

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Authors and Affiliations

  1. Sicherheit und Ordnung, Gefahrenabwehr, Rettungsdienst Kreis Herford, Wittekindstr. 7, 32051, Herford, Germany

    Steffen Grautoff

  2. Zentrale Notaufnahme, Klinikum Herford, Schwarzenmoorstr. 70, 32049, Herford, Germany

    Steffen Grautoff

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  1. Steffen Grautoff
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Correspondence to Steffen Grautoff.

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S. Grautoff declares that he has no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case. Additional written informed consent was obtained from all individual participants or their legal representatives for whom identifying information is included in this article.

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Grautoff, S. QRS double counting by ECG software in ST elevation myocardial infarction. Herzschr Elektrophys 34, 75–77 (2023). https://doi.org/10.1007/s00399-023-00925-8

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  • DOI: https://doi.org/10.1007/s00399-023-00925-8

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