Holter: Artefact Mime of VT

Report:

Sinus rhythm

VEBs, multiform, one dimorphic couplet (bottom panel)

Movement artefact 295/min, uncertain origin

Comment:

The “run” in the top panel has an unlikely fast rate of almost 300/min, but it looks scary, especially in a patient fitted with an ICD for recurrent VT. It starts with a VEB and ends spontaneously in the middle panel.

Fortunately, a three-channel recording shows the correct diagnosis: the bottom channel shows the patient’s basic rhythm throughout the “paroxysm”.

Similar, but slower run of the same artefact is shown below (Fig 285a). The technicians assured me it was not a “ghost” from incompletely erased tape, because nothing of the kind had ever been seen on anyone else’s Holter.

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