Authors' reply

EDITOR,—In response to Tom Snow, our purpose in using as an illustration the ward observation chart showing the apex-radial pulse deficit in a patient with atrial fibrillation was not to condone the routine recording of this. Indeed, we did not even discuss it as part of routine clinical management. However, the pulse deficit is abolished after a return to sinus rhythm, and this may be useful in the clinical examination of patients with paroxysmal atrial fibrillation. …