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Pericarditis: Not a Cause of Arrhythmias

David H. Spodick, MD, DSc
Arch Intern Med. 1986;146(1):207. doi:10.1001/archinte.1986.00360130249045.
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To the Editor.  —The interesting and valuable article by Louie et al, "Pancreatic Pleuropericardial Effusions,"1 is marred by a small but diagnostically and conceptually important error: "The various dysrhythmias described in acute pancreatitis could be ascribed to pericardial irritation.... " In large retrospective and prospective studies of arrhythmias in pericarditis of mixed causes it has been consistently shown that pericarditis is not a cause of arrhythmias.2-4 Significant arrhythmias occur only in the presence of anatomic heart disease and in a few cases of critical tamponade (ie, physiologic heart disease). This error has appeared previously in the Archives and other journals despite efforts to correct it. One hopes that reviewers will be more careful with such material (one of many reasons that the EDITOR'S CORRESPONDENCE is a vital "check and balance on the peer review system").5


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