Auricular Flutter and Fibrillation

To the Editor: —In his letter to the Editor which appeared inThe Journalof Oct. 6, 1951, Dr. Ernest B. Zeisler has advanced arguments supporting the circus theory of auricular fibrillation. Dr. Zeisler states that auricular flutter there is an underlying circus movement and suggests that, since auricular flutter and auricular fibrillation sometimes merge into each other, there may also be a circus in auricular fibrillation. In an article published in the American Journal of Medicine for October, 1951, evidence is presented that neither a main circular wave nor daughter waves exist in auricular flutter. Dr. Zeisler reasons further that in auricular fibrillation the chaotic activity may be largely the result of daughter waves arising from the main irregular circus pathway. In oscilloscopic studies of auricular fibrillation, no evidence suggesting the presence of either a main circus wave or daughter waves could be obtained from an