Occipital Localization of Electrocardiographic Artifacts in Pediatric Electroencephalograms: A Novel Observation and Implications
Artifacts during electroencephalography (EEG) are a common interference with the interpretation of recordings.[1,2,3] Electrocardiographic (EKG) artifacts are common extracerebral artifacts generated by cardiac electrical activity. They are usually eliminated by the common mode rejection by the differential amplifiers. The artifact becomes visible if the EKG activity is not identical at different electrodes and the common mode rejection does not eliminate the EKG activity. They are prominent in individuals with short and wide necks. The magnitude of the EKG potential recorded at an electrode depends on its distance from the heart and the direction of the cardiac vector. In adults, EKG artifacts are best recorded in a referential montage with ear lobe reference electrodes. Its negativity (upward deflection) is seen on the left temporal electrodes and positivity (downward deflection) on the right temporal electrodes as the cardiac mean QRS axis is directed downwards and to the left (range −30 to +90 degrees)