Abstract
To the Editor:— Identification of P waves is one of the most important steps in the diagnosis of cardiac arrhythmias. The esophageal lead is well established as a practical tool for this purpose. Should one not be available, I have found that a satisfactory substitute can quickly be assembled. A small-caliber feeding tube is selected. A length of stainless-steel suture material is passed through the tube. The suture is tied to the lower end of the feeding tube with a running clove hitch and its free end tucked under the knot. This type of tie provides adequate area for contact with the esophagus. The other end of the suture is wound around the chest lead of the patient cable and secured with a hemostat. The feeding tube is then coated with ordinary surgical lubricant and passed in the usual manner.
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