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To the Editor: After reading a recent article in your journal entitled "Feinting science: Neurocardiogenic syncope and collateral vasovagal confusion" by Landau and Nelson,1 our first thoughts were on why a reputable journal would waste publication space with such material. Nevertheless, it is necessary to respond to give your readers a more balanced view on the subject.
It is not possible, in a reasonable amount of space, to correct every inaccuracy in the manuscript, but several are worth mention. On page 610 the authors grossly exaggerate the cost of several cardiovascular procedures. At our institution the cost (including physician fees) of a tilt-table test is approximately $1000, not $3900 as they claim. In addition, their estimate of the cost of a diagnostic electrophysiology study is again exaggerated.
One page 613, they pay homage to Sharpey-Schafer's 1956 description of the pathophysiology of syncope; this description includes the erroneous …
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