Spurious ST segment depression by automated ST segment analysis.

Perioperative myocardial ischemia has been shown to be predictive of adverse cardiac outcome [1]. One method of detecting intraoperative myocardial ischemia is automated ST segment monitoring [2]. The rationale behind automated ST monitoring is that the clinician will be promptly alerted to ischemic changes in the ECG. This may lead to earlier intervention and, perhaps, improved outcome [3]. We describe a case in which automated ST segment monitoring falsely signaled the presence of intraoperative ST segment depression. This event emphasizes the importance of confirming the validity of ST segment changes before instituting therapy.