TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR-INDUCED ELECTROCARDIOGRAM ARTIFACT

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Abstract
Transcutaneous electrical nerve stimulation (TENS) is an effective modality for the treatment of pain. TENS use is well tolerated and has relatively few complications. Potentially serious complications of TENS use include disruption of cardiac pacemaker function and electrical artifact during electrocardiographic monitoring. Electrical interference with cardiac monitoring using parasternal electrodes and electrocardiographic (EKG) artifact with an epidural stimulator has been reported. We report the case of EKG artifact produced by surface TENS electrodes applied to the thoracic and lumbar regions. The electrical signal produced by the TENS unit created an electrocardiographic artifact resembling a pacemaker spike on routine EKG. This was interpreted as a malfunctioning cardiac pacemaker. The easily misinterpreted electrical spikes that can result from TENS use as seen in this case highlights the need for physician awareness of this potential complication.