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July 21, 1978

Cardiac Arrest vs Extreme Bradycardia

JAMA. 1978;240(3):213. doi:10.1001/jama.1978.03290030031010

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To the Editor.—  An inquiry was recently made by Stern and Keren (239:403, 1978) as to whether a reported cardiac arrest following routine venipuncture (236:1846,1976) was instead an extreme case of sinus bradycardia. Stern and Keren attempt to compare a reported asymptomatic patient who sustained a cardiac arrest following routine venipuncture in an outpatient office setting with their experience with a patient who lost consciousness after a routine venipuncture in their Coronary Care Unit. In reviewing their case report, one notices that their patient was admitted to the Coronary Care Unit with a history of chest pain and, while his ECG was being constantly monitored, went into extremely slow sinus rhythm after a routine venipuncture and responded well to intravenous atropine.One cannot, in all fairness, compare these two patients for a variety of reasons, such as presence of chest pains and ECG monitoring. The most important issue facing a