Fake Atrial Fibrillation — A Growing Patient-Safety Issue

Fake atrial fibrillation (AF) is a growing problem. This is when the computer-reading on an ECG calls the rhythm AF, but it is not AF. When the doctor does not recognize the faulty read, the patient is misdiagnosed. Here are three pictures from the last month. (I have a stack of these.) Notice the computer-read at the top. Fake AF — This is sinus rhythm with periods of variable AV block Fake AF — This is sinus rhythm with PVCS Fake AF — This is sinus tachy The weird thing about misdiagnosed AF or fake AF is that it’s getting worse as our technology gets better. I think I know why. In the really old days, say twenty-five years ago, ECG tracings did not come with computer-reads. An ECG included only the raw data, the electrical signals from the heart. This meant doctors had to look at the actual tracing and interpret it. Skilled ECG readers then passed this knowledge along to students and nurses and technologists. The result was that most caregivers knew how to recognize AF and other important patterns, such as heart attacks. The diffusion of ECG skills was like herd immunity, only it was herd knowledge. That has changed for the worse. Computer readings of the ECG have gradually eroded knowledge of the herd. When computer-reads were first added to ECGs, doctors knew to look away from the computer’s call and see the actual signals. Over the years, the eyes and brains of doctors have been drawn to the computer-read. It should be the opposite. The com...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs