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Abstract
To the Editor: A 65-year-old woman called paramedics because of cardiac palpitations. At the scene the patient had a regular sinus rhythm with a heart rate of 75 beats per minute. Her heart and lungs were normal. The patient was placed in the ambulance and transported to the hospital. During transport, the electrocardiogram monitor showed what appeared to be intermittent atrial flutter with a high degree of block (Fig. 1). The change in rhythm was intermittent and lasted one or two minutes at a time. The rhythm change was not accompanied by changes in vital signs.Upon close observation of . . .

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