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Arrhythmias During Acute Pericarditis

William H. Wehrmacher, MD
JAMA. 1976;235(22):2390. doi:10.1001/jama.1976.03260480012011.
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To the Editor.—  Dr Spodick's interesting perspective study of 100 consecutive cases of pericarditis (235:39, 1976) casts serious doubt, that should not go unchallenged, on the generally accepted role of pericarditis as a cause for atrial arrhythmias. Continuing clinical experience, as well as our published study of 90 cases of acute pericarditis, support precisely the opposite conclusion and are in accord with the references from Friedberg's Diseases of the Heart and T. N. James' publications refuted by Dr Spodick.Among the 90 patients that form the basis of our published report, ten (11%) had atrial arrhythmias (six, atrial fibrillation; two, atrial flutter; two, atrial tachycardia) of which only three had been recognized clinically before electrocardiograms were recorded. We cannot attribute these arrhythmias, as Spodick suggests, to coincidental cardiac disease of another origin; we had specifically excluded pericarditis secondary to myocardial infarction, rheumatic carditis, and metastatic and collagen disease. Thus, in


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