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February 1, 1965

Complications of Direct-Current Countershock

JAMA. 1965;191(5):421. doi:10.1001/jama.1965.03080050067031

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To the Editor:—  In the communication by Rabbino, Likoff, and Dreifus on complications and limitations of direct-current precordial countershock (JAMA190:417 [Nov 2] 1964) there are three examples of ventricular fibrillation.The preshock electrocardiographic tracing of case 1 is described in the text and in Fig 1 as paroxysmal atrial tachycardia with 2:1 atrioventricular block. A close examination of the tracing, however, reveals a double tachycardia, with a regular atrial rate of 250 beats per minute, and a regular nodal mechanism at 150 beats per minute, with complete dissociation and heart block. It seems necessary to correct this error since a final list of indications and contraindications for this valuable form of therapy must take into account the exact electrocardiographic mechanism of the arrhythmia.

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