Artificial pacemakers and automatic implantable cardioverter-defibrillators are life-saving devices that generally improve patient quality of life. However, some patients report adverse effects such as anxiety, depression, and phantom shocks or, less often, phantom arrhythmia. The authors report the case of an 81-year-old woman who received a permanent artificial pacemaker and later described having rapid and irregular heartbeats and "pounding sounds," which were suggestive of arrhythmia. However, a cardiac event monitor did not document any abnormalities. Although literature is limited regarding the phenomenon of phantom arrhythmia, the authors propose to define it as a cluster of symptoms suggestive of an arrhythmia perceived by a patient but not clinically verified.

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