It is well recognized clinically that in patients having auricular fibrillation or flutter with grossly irregular pulses determinations of the blood pressure by the ordinary auscultatory and palpatory methods not only are difficult to obtain but are subject to considerable error. Several methods have been suggested by which the average systolic blood pressure may be obtained,1 and these, in general, are based on the number of pulse beats which come through or fail to come through at different cuff pressures. These indirect methods require two observers and laborious calculations, and their significance may be questioned on theoretic grounds. Because of this unsatisfactory situation we felt it desirable to reinvestigate this subject by actually determining the blood pressure directly by intra-arterial puncture. This we felt would permit us not only to obtain the actual values but to establish the factors responsible for their variation from beat to beat.
BUCHBINDER WC, SUGARMAN H. ARTERIAL BLOOD PRESSURE IN CASES OF AURICULAR FIBRILLATION, MEASURED DIRECTLY. Arch Intern Med (Chic). 1940;66(3):625–642. doi:10.1001/archinte.1940.00190150096007
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