What Is Ashman Phenomenon?

Mary McMahon

Ashman phenomenon is an irregularity of ventricular contraction that can be seen in some patients. Also known as Ashman beats, these abnormalities occur when the heart’s rhythm is disrupted. It is usually asymptomatic, but can be confused with other types of heart arrhythmias. For this reason, medical providers need to be aware of the possibility of Ashman phenomenon along with other types of arrhythmias so they can read Electrocardiogram (ECG) tracings correctly and identify what is happening inside the patient’s heart.

To read electrocardiogram tracing correctly, medical practitioners must know about the possibility of Ashman phenomenon.
To read electrocardiogram tracing correctly, medical practitioners must know about the possibility of Ashman phenomenon.

This phenomenon was first documented in 1947 and is named for one of the researchers who submitted the original paper. It can be identified on a tracing by looking for the QRS complex, the distinctive dip, spike, and dip of the Q, R, and S waves in the heartbeat. These normally remain fairly consistent. In a patient exhibiting Ashman phenomenon, an extended QRS complex will appear after a relatively short interval, interrupting the normal pattern of the ECG tracing.

A patient with Ashman phenomenon should ask that the irregularity be noted in his charts to ensure later healthcare providers are aware of the issue.
A patient with Ashman phenomenon should ask that the irregularity be noted in his charts to ensure later healthcare providers are aware of the issue.

Such tracings can be ordered to evaluate a patient with a suspected heart problem or to determine the nature of an abnormality detected on a physical examination. They can also be part of a workup to assess a patient’s physical fitness. The more detail from the tracing, the more accurate the reading can be; technicians need some skill to place the leads correctly and administer the test for clean results..

During an electrocardiogram, electrodes are placed on the skin to monitor electrical impulses inside the heart.
During an electrocardiogram, electrodes are placed on the skin to monitor electrical impulses inside the heart.

Arrythmias like ventricular tachycardia and ventricular premature contractions can be confused with Ashman phenomenon. When a patient appears to have an abnormal ECG, a careful evaluation is recommended to determine the specifics of the case. Special training in evaluating heart rhythms is provided to people like cardiologists, who need to be able to interpret tracings that are sometimes nebulous or confusing. They review the available data and the patient history to determine what kind of heart rhythm is appearing.

Once Ashman phenomenon is recognized, no additional steps need to be taken. The condition is benign and shouldn’t cause any problems for the patient, though may be noted in a chart so others are aware the abnormality has been recognized and evaluated. This can reduce the risk that the patient will be asked to undergo repeat testing or followups for a heart arrhythmia that isn’t a significant issue. Patients may want to take note of the fact that they have Ashman beats because it could come up in emergency medical treatment, where the abnormal rhythm might cause concern for paramedics and other first responders.

Ashman beats occur when the heart's rhythm is disrupted.
Ashman beats occur when the heart's rhythm is disrupted.

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