Can we trust our ECG machines?

June 2014Br J Cardiol 2014;21:62–3 4 Comments

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Authors: Heather Wetherell

The article on pages 47–8, by Drs Derek Rowlands and Philip Moore, highlights the importance of maintaining our clinical skills at electrocardiogram (ECG) interpretation. The authors touch upon the unsatisfactory reliance on computer analyses. The frequent inaccuracy of computer-generated ECG interpretation is well recognised, yet how many of us in primary care, still fall back on this? The machine diagnostics can so easily mislead us. Always check it yourself, and consider your findings in conjunction with the clinical presentation.

Today, we’re doing a confidence test …

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4 thoughts on “Can we trust our ECG machines?”

ECG 2 and the VE that isn’t—you say “Note that it is seen in limb lead II (on rhythm strip) but not mirrored in the chest leads.” But while it looks at first glance as if the long lead 2 was recorded with the others, for three quarters of its length the complexes are out of sync with those in the aV and chest leads. I can’t make sense of this—most ECGs I see seem to have the long lead II recorded at the same time as the others. Looking at the 4 other ECGs in this piece, I see exactly the same–the long lead II recorded in sync with I, II and III but then getting out of sync. A further fault with this particular machine?

Many apologies all – ECG3 does indeed show Atrial Flutter with a avrable 3:1 , 2:1 block. Really sorry for this error. Thanks for picking this up.
Correction comment now added but unfortunately the “print” copy of the Journal has already gone out.

Thank you Dave. I”ll dig out the original and take a closer look. I know the patient well, so I”ll bring her back to repeat if necessary!
Many thanks for taking the time to comment.

An excellent article by Dr Wetherell, illustrating nicely why we can’t rely on automatic computer interpretation of ECGs. However, I’m pretty sure that ECG 3 shows atrial flutter rather than atrial trigeminy (flutter waves can be seen in leads III and V1), which only goes to show that rhythm analysis can be tricky for humans as well as computers.

Can we trust our ECG machines?

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