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Pericarditis and the Sick Sinus Syndrome

David H. Spodick, MD, DSc
Arch Intern Med. 1985;145(10):1930. doi:10.1001/archinte.1985.00360100204046.
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To the Editor.  —In their excellent review of current concepts of sick sinus syndrome, Belie and Talano1 unfortunately included "pericarditis" as one of its causes. In a professional lifetime of studying and dealing with pericarditis, I cannot recall seeing such a case—or reading of such a case in a steady and rather compulsive attention to the literature. (Several years ago we reviewed our experience with sick sinus syndrome, some 78 cases in four years, and did not find pericarditis among this small group.) More importantly, the only studies using a prospective protocol of rhythm disturbances in pericarditis—100 cases followed clinically and by electrocardiogram2 and 50 cases by Holter monitoring3—showed no association of pericarditis with arrhythmias. Unfortunately, textbooks commonly repeat the hoary notion that there must be a relationship. Moreover, repeated misinterpretations of James'4 article tend to perpetuate this.The uniform conclusion of the prospective,


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