Pseudoarrhythmia Caused by Temporary Transvenous Pacemaker

THE INTERPRETATION of arrhythmias on a 12-lead scalar electrocardiogram or on a monitoring strip can frequently be a difficult task. Essential to the interpretation is a good-quality stable baseline without artifacts. We are dependent on proper electrode placement, faultless technical assistance, and quality equipment. Unfortunately, artifacts are not uncommon in full 12-lead scalar ECGs because the equipment must fulfill American Heart Association standards of a wide frequency response range from 0.05 to 100 hertz. With this wide frequency range, the scalar ECG is subject to motion artifacts from respiration, arm movement, muscle tremors such as parkinsonism, and high-frequency electrical signals such as 60-Hz interference. Fortunately, bedside monitors are provided with a low- and high-frequency cutoff that eliminates most artifact. Our patient had a temporary transvenous pacemaker that caused an unusual ventricular pseudoarrhythmia during monitoring. This points out the need for caution in interpretation and treatment of a patient with an