Editing Electrocardiography (section)

===Artifacts===
An ECG tracing is affected by patient motion. Some rhythmic motions (such as shivering or [[tremor]]s) can create the illusion of cardiac arrhythmia.<ref>{{Cite journal |last1=Segura-Sampedro |first1=Juan José |last2=Parra-López |first2=Loreto |last3=Sampedro-Abascal |first3=Consuelo |last4=Muñoz-Rodríguez |first4=Juan Carlos |year=2015 |title=Atrial Flutter EKG can be useful with the proper Electrophysiological Basis |journal=International Journal of Cardiology |volume=179 |pages=68–69 |doi=10.1016/j.ijcard.2014.10.076 |pmid=25464416}}</ref> Artifacts are distorted signals caused by a secondary internal or external sources, such as muscle movement or interference from an electrical device.<ref name="Takla">{{Cite journal |last1=Takla |first1=George |last2=Petre |first2=John H. |last3=Doyle |first3=D John |last4=Horibe |first4=Mayumi |last5=Gopakumaran |first5=Bala |s2cid=10614183 |year=2006 |title=The Problem of Artifacts in Patient Monitor Data During Surgery: A Clinical and Methodological Review |journal=Anesthesia & Analgesia |volume=103 |issue=5 |pages=1196–1204 |doi=10.1213/01.ane.0000247964.47706.5d |pmid=17056954|doi-access=free }}</ref><ref>{{Cite journal |last1=Kligfield |first1=Paul |last2=Gettes |first2=Leonard S. |last3=Bailey |first3=James J. |last4=Childers |first4=Rory |last5=Deal |first5=Barbara J. |last6=Hancock |first6=E. William |last7=van Herpen |first7=Gerard |last8=Kors |first8=Jan A. |last9=Macfarlane |first9=Peter |date=2007-03-13 |title=Recommendations for the standardization and interpretation of the electrocardiogram: part I: The electrocardiogram and its technology: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: endorsed by the International Society for Computerized Electrocardiology |journal=Circulation |volume=115 |issue=10 |pages=1306–1324 |doi=10.1161/CIRCULATIONAHA.106.180200 |pmid=17322457|doi-access=free }}</ref>

Distortion poses significant challenges to healthcare providers,<ref name="Takla" /> who employ various techniques<ref>{{Cite web |url=https://www.physio-control.com/WorkArea/DownloadAsset.aspx?id=2147489452 |title=Minimizing ECG Artifact |date=2015 |website=Physio-Control |publisher=Physio-Control, Inc., Redmond WA |format=PDF |access-date=21 October 2017}}</ref> and strategies to safely recognize<ref name="Fahim H Jafary">{{Cite journal |last=Jafary |first=Fahim H |year=2007 |title=The "incidental" episode of ventricular fibrillation: A case report |journal=Journal of Medical Case Reports |volume=1 |issue=1 |pages=72 |doi=10.1186/1752-1947-1-72 |pmc=2000884 |pmid=17760955 |doi-access=free }}</ref> these false signals.{{medical citation needed|date=August 2015}} Accurately separating the ECG artifact from the true ECG signal can have a significant impact on patient outcomes and [[Legal liability|legal liabilities]].<ref>{{Cite journal |last1=Mangalmurti |first1=Sandeep |last2=Seabury |first2=Seth A. |last3=Chandra |first3=Amitabh |last4=Lakdawalla |first4=Darius |last5=Oetgen |first5=William J. |last6=Jena |first6=Anupam B. |year=2014 |title=Medical professional liability risk among US cardiologists |journal=American Heart Journal |volume=167 |issue=5 |pages=690–696 |doi=10.1016/j.ahj.2014.02.007 |pmc=4153384 |pmid=24766979}}</ref>{{UNMED|date=August 2015}}

Improper lead placement (for example, reversing two of the limb leads) has been estimated to occur in 0.4% to 4% of all ECG recordings,<ref>{{Cite journal |last1=Batchvarov |first1=Velislav N. |last2=Malik |first2=Marek |last3=Camm |first3=A. John |date=November 2007 |title=Incorrect electrode cable connection during electrocardiographic recording |journal=Europace |volume=9 |issue=11 |pages=1081–1090 |doi=10.1093/europace/eum198 |pmid=17932025 |doi-access=free }}</ref> and has resulted in improper diagnosis and treatment including unnecessary use of [[thrombolytic]] therapy.<ref>{{Cite journal |last=Chanarin N., Caplin J., Peacock A. |year=1990 |title="Pseudo reinfarction": a consequence of electrocardiogram lead transposition following myocardial infarction |journal=Clinical Cardiology |volume=13 |issue=9 |pages=668–669 |doi=10.1002/clc.4960130916 |pmid=2208827|doi-access=free }}</ref><ref>{{Cite journal |last=Guijarro-Morales A., Gil-Extremera B., Maldonado-Martín A. |year=1991 |title=ECG diagnostic errors due to improper connection of the right arm and leg cables |journal=International Journal of Cardiology |volume=30 |issue=2 |pages=233–235 |doi=10.1016/0167-5273(91)90103-v |pmid=2010249}}</ref>