AANEM Connect

AANEM-Connect-Final

Join this vibrant community of professionals eager to exchange ideas, share resources, and engage in meaningful discussions. Use this platform as a sounding board to seek advice for navigating challenging cases or career decisions, and receive expert guidance from generous peers who want to help you succeed.

AANEM Connect

Has anyone seen this apparent Zio patch artifact on EMG?

Cole Denkensohn5/31/24 2:34 PM (CDT)

Hey all,

Im not sure if this is the right forum for this question, but I figured I'd give it a shot.

I did an EMG on a young patient with a clinical history of left UNE, and the nerve studies confirmed that localization. I proceeded to a root screen with the needle to evaluate for additional radiculopathy, and all muscles were normal except for one finding. When I inserted the needle in the left biceps at rest, I saw/heard what looked like a fib firing quite regularly at around 1 hz. There was some subtle variability to it, and it remained as I moved the needle around to sample different regions. 

He was wearing a zio patch, and while I didn't think this device put out any signal (just read), I put my finger on his radial pulse and the "fib" seemed to follow his pulse. 

The above led me to consider that maybe this could somehow be a zio-patch related artifact. Has anyone seen this?

I think a true fib is less likely because of the subtle variability (not just linear slowing or speeding up) and the fact that it continued as I moved the needle around.

I think a volitional motor unit is less likely because of the morphology and firing speed.

Thank you for any thoughts!

There are 3 responses to this thread.

In order to comment on posts and view posts in their entirety, please login with your AANEM member account information.

I enjoy participating in the AANEM Connect Forum for a number of reasons. There are very fundamental questions posed on a frequent basis that cause me to pause and ask myself, ‘Why didn’t I think of that?’ Also, I continue to learn new things when others contribute their thoughts and experiences. Connect is an excellent opportunity for members to interact and to address any topic, including those that may not be discussed at an annual meeting or journal article.

Daniel Dumitru, MD, PhD