Scenario: This electrocardiogram (ECG) was from a 47-year-old man with a history of hypertension and prior tobacco use, as well as a significant family history of coronary artery disease. He was being followed up by a cardiologist after experiencing episodes of palpitations, chest tightness, and heart “fluttering” starting about 2 weeks prior. The episodes occurred several times a day, were associated with shortness of breath, and resolved after a few seconds. To assess for potential arrhythmias, a 2-day Holter recorder was applied. Simultaneously, the patient consented to participate in a clinical trial to evaluate the usefulness of a mobile monitoring device in outpatients with palpitations. The study protocol included instructions about recording an ECG with the device during symptoms for the next 30 days. On day 4 of the study, the 6-lead ECG (6 limb leads) below was transmitted to the research nurse during a “heart fluttering” episode.

Irregularly...

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