Simultaneous electrocardiography and Doppler echocardiography in pulsus alternans

Pulsus alternans, the alternating strong and week pulses which occur in patients with severe heart failure, was first described by Traube in 1872. Since then various methods, both invasive1,2 and non-invasive3,4, have been used to study this phenomenon. This study demonstrates the utility of using simultaneous electrocardiography (ECG) and Doppler echocardiography to document pulsus alternans, and to differentiate it from other causes of alternating pulses.