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Document Details : Title: Oral anticoagulation for ECG tremor artefact simulating atrial fibrillation Author(s): FINSTERER, Josef , STÖLLBERGER, Claudia , GATTERER, Edmund Journal: Acta Cardiologica Volume: 58 Issue: 5 Date: October 2003 Pages: 425-429 DOI: 10.2143/AC.58.5.2005308 Abstract : That tremor simulates atrial fibrillation and causes oral anticoagulation has not been reported. In a 69-year-old patient with diabetes, arterial hypertension and recurrent strokes, hand tremor developed since 1998. In September 2000 atrial fibrillation was diagnosed upon a routine and 24-hour ambulatory ECG. Because of the additional risk factors for stroke/embolism, phenprocoumon was begun.The diagnosis was changed to paroxysmal AF upon the following ECGs,showing sinus rhythm. Not earlier than 1 year after establishing the diagnosis,“atrial fibrillation” was identified as being due to a tremor artefact.Phenprocoumon was discontinued.Neurological investigations revealed Parkinson’s disease as the cause of the tremor.Three weeks after initiation of pramipexol,the tremor artefact was no longer visible on ECG. Misinterpreting an ECG-artefact due to Parkinsons’s tremor as atrial fibrillation may be followed by unnecessary diagnostic and therapeutic procedures, including long-term oral anticoagulation.Upon adequate treatment of Parkinson’s disease,the tremor artefact immediately disappears from the ECG. |
