LETTER
Heart Rate Alternans
David H. Spodick, MD, DSc
1 September 1995 | Volume 123 Issue 5 | Pages 393-394
TO THE EDITOR:
Although their report of the power-density spectrum of heart rate variability is new and valuable, Binkley and colleagues' [1] belief that they have discovered heart rate alternans in pulsus alternans is mistaken. Their patient's cycle length alternation is reported as uncharacteristic; however, the opposite is true. Heart rate cycle alternation has been known for many decades and was always seen in our investigations [2, 3] of pulsus alternans. Indeed, in 1956, Friedman [4] carefully reviewed this characteristic phenomenon, with a good discussion of its probable causes. Unfortunately, this information must have escaped the peer reviewers, whose work we depend on to ensure high standards of scientific dependability [5].
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Author and Article Information
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Saint Vincent Hospital; Boston, MA 01604
1. Binkley PF, Eaton GM, Nunziata E, Khot U, Cody RJ. Heart rate alternans. Ann Intern Med. 1995; 122:115-7.
2. Spodick DH, St. Pierre JR. Pulsus alternans. Physiologic study by nonivasive techniques. Ann Heart J. 1976; 80:766-77.Appendix.
3. Spodick DH, Khan AH, Pigott VM. Systolic and diastolic time intervals in pulsus alternans. Am Heart J. 1974; 87:5-10.
4. Friedman B. Alternations of cycle length impulsus alternans. Am Heart J. 1956; 51:701-12.
5. Spodick DH. Peer review system ACP Observer. 1985; 5:9-10.
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