Myocardial Laceration Not Demonstrated by Continuous Electrocardiographic Monitoring Occurring during Pericardiocentesis

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Abstract
IN 1951 Bishopetal.described the technic of percutaneous pericardiocentesis with continuous electrocardiographic monitoring in which the paracentesis needle serves as an exploring electrode.1 With this procedure, an injury current is detected if the needle contacts the ventricular (ST-segment elevation) or a trial (PR-segment elevation) epicardium. Numerous studies have shown the technic to be of value in preventing inadvertent myocardial puncture and to clarify the site of origin of bloody fluid.1 2 3 4 In the reported exceptions, myocardial penetration and laceration was accompanied by electrocardiographic changes when this technic was used.5 6 7 8 We recently encountered a circumstance in which a definite myocardial laceration occurred without . . .