WILLIAM HARPER, M.D., F.A.C.P.
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To the editor: The article on transient cerebral ischemia due to arrhythmia by Walter, Reid, and Wenger (Ann Intern Med 72:471-474, 1970) noted the need to consider episodic tachy- or brady-arrhythmias in the differential diagnosis of patients with otherwise unexplained symptoms of cerebrovascular insufficiency.
Having lived in Holter's home town (1), we had the opportunity to work closely with him and the continuous ECG for over a decade, and early on the frequency of various arrhythmias in persons with normal resting ECGs was noted. Knowing that the hypotension accompanying either tachycardia on bradycardia could lead to central nervous system symptoms,
HARPER W. Cardiac Arrhythmia and Cerebral Ischemia. Ann Intern Med. ;73:341. doi: 10.7326/0003-4819-73-2-341_2
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Published: Ann Intern Med. 1970;73(2):341.
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