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October 6, 1951


Author Affiliations

104 S. Michigan Ave., Chicago.

JAMA. 1951;147(6):595. doi:10.1001/jama.1951.03670230061023

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To the Editor:  —In the Aug. 4, 1951, issue of The Journal (page 1275), Prinzmetal and his co-workers report their splendid observations on spontaneous and induced auricular fibrillation. They then say that their observations are "entirely incompatible with" the circus movement hypothesized by Lewis, so that "The conclusion is inevitable that no circus movement occurs in auricular fibrillation." Whether the conclusion is correct is one question, but I do not believe it is inevitable from their observations.They say that "If a single excitation wave traveled around the fibrillating auricles along a roughly circular path, as hypothesized by Lewis, some type of synchronism would be present in simultaneously recorded leads from various sites on or near the circuit.... Furthermore, the absence of isoelectric intervals in the oscillogram indicates that the 'isoelectric gap,' which is essential to the perpetuation of the circus movement, does not exist." This argument is, I believe,

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