DAVID H. SPODICK, M.D., D.SC.
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To the editor: The paper by Chandraratna and colleagues (Ann Intern Med 87:199-200, 1977) nicely presents a useful technique for pericardiocentesis. I wish to take exception, however, to the statement that electrocardiographic monitoring of pericardial puncture is "routinely used." The authors mention that ECG changes may not be evident when the exploring needle penetrates the myocardium, and indeed they penetrated the right ventricle without any ST segment changes or extrasystoles in the precordial lead (but of course extrasystole would be seen in either a precordial lead or intrapericardial lead). Work on dogs showed this to be true also for the
SPODICK DH. Electrocardiography During Pericardiocentesis. Ann Intern Med. ;87:791. doi: 10.7326/0003-4819-87-6-791_1
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Published: Ann Intern Med. 1977;87(6):791.
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