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December 15, 2004

Fascinating Rhythm

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(23):2836. doi:10.1001/jama.292.23.2836-a

To the Editor: The Grand Rounds by Dr Ziegelstein on near-syncope after exercise1 sent me back nearly 40 years when, as a senior medical resident at Henry Ford Hospital, I encountered a similar unforgettable patient. I considered myself a good history taker, but no matter how I probed and cajoled, all I could ever get this 66-year-old man to say was “I get that unnecessary feeling.” He just wouldn’t elaborate. I had an interest in carotid sinus hypersensitivity and so I performed carotid sinus massage. Just as the electrocardiogram began to show the classic ventricular pause demonstrated in the article, the patient exclaimed, “That’s it!” “What?” I asked. “I just got that unnecessary feeling,” he said. I did too, until his normal rhythm resumed.

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