Electrocardiography pitfalls and artifacts: the 10 commandments.

Artifacts are common in patients who require ECG monitoring. Artifacts can simulate arrhythmias such as atrial flutter and ventricular tachycardia and lead to inappropriate treatment. Electrode and lead misplacements are another common pitfall and can lead to ECG changes that may be interpreted as ischemic in origin and can mimic serious arrhythmias. A simplified algorithm (REVERSE is the mnemonic) may help clinicians correctly identify both suspected electrode misplacements and artifacts.