Pseudoatrial Flutter: Artifact Simulating Atrial Flutter Caused by a Transcutaneous Electrical Nerve Stimulator (TENS)

A patient with previous actual atrial flutter had what appeared to be atrial flutter seen on Holter monitoring during treatment with a transcutaneous electrical nerve stimulation (TENS) unit. This proved to be artifact caused by the unit rather than a true arrhythmia. The artifact was reproduced in a normal volunteer by application of a TENS unit.