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March 5, 1973

False Atrial Flutter From Nasogastric Suction Pump

Author Affiliations

University of Virginia Medical Center Charlottesville

JAMA. 1973;223(10):1160. doi:10.1001/jama.1973.03220100054025

To the Editor.—  Parkinsonian tremor and hiccups,1 a roller pump used in hemodialysis,2 myoclonic movement (211:829, 1970), and broken electrocardiographic electrode wires (220:1130, 1972) have caused false atrial arrhythmias. Recently we observed electrocardiographic artifacts that mimicked atrial flutter during nasogastric suction with a roller pump. When seen by us, a patient with intestinal obstruction had no muscle tremor or hiccups, had been given digitalis for a short term for what was thought to be atrial flutter, and was connected to an Air-Shields Drainage Pump (model DP-45-1) via nasogastric tubing. False atrial flutter occurred only during suction and completely disappeared whenever the pump was turned off or suction tubing disconnected, thus ruling out atrial dissociation (Fig). Further testing of the drainage pump, electrocardiographic recorder and electrodes, and alternating current wall receptacle showed that this artifact was not electrically induced, but rather mechanically caused by the roller pump as it regularly