title: The diagnostic dilemma of "pseudopacemaker spikes".
abstract: In a patient who sustained sudden collapse, later attributed to pulmonary embolization, an ECG during her evaluation demonstrated sinus tachycardia and stimulus artefacts at a rate of 250 per minute which did not capture the heart. Implanted pacemaker malfunction was considered the cause until a chest X ray showed a transcutaneous electrical nerve stimulation (TENS) device, which was the source of the artefacts. In instances of rapid stimulus artefacts on the ECG that do not capture the heart, the presence of a TENS device should be considered.
authors.affiliation: Derriford Hospital, Plymouth, United Kingdom.
authors.forename: A J
authors.initials: AJ
authors.lastname: Broadley
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D009101:Multiple Myeloma / Q000175:diagnosis; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011655:Pulmonary Embolism / Q000175:diagnosis; D013616:Tachycardia, Sinus / Q000175:diagnosis; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects