[Interpretation of the normal and pathological magnetocardiogram, based on 140 thoracic chestings (author's transl)].
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A review and discussion of the incidence and clinical importance of various cardiac arrhythmias in patients with inflammatory diseases of the heart is presented in this paper.
The authors report on 4 Intensive Care Unit cases, hospitalized for syncopes due to serious ventricular arrhythmias. They all presented long Q-T and were receiving treatment with prenylamine. Improvements were observed on suspension of the drug, suggesting therefore that during this treatment, frequent electrocardiographic checks, especially for elderly patients, should be carried out. Caution should also be exercised in associations with other chinidinosimiles and hypokaliemic drugs
2 patients with symptoms of paroxysmal AV block showed widening, splitting, slurring and decreasing amplitude of the His potential. Concomitantly, this was followed by different patterns of bundle branch block. In one of the patients it was obvious that a left bundle branch block was related to a Wenckebach phenomenon in the His bundle, and in the other patient different bundle branch block patterns were related to the occurrence of the intra-His bundle conduction delay. It is suggested that the present electrophysiological findings reflect asynchronous conduction in the His bundle causing a critical conduction delay in parts of the bundle branches leading to bundle branch block.
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It was established that the presence of Samoilov-Wenckebach's periods and prolongation of the H--V interval at low frequency of the imposed rhythm as well as periods of asystolia of more than 1,200 msec are most typical for these patients. An attempt was made to determine the type of cardiac stimulation indicated for such patients from the character of the disorders of rhythm observed in them and the initial frequency of their own cardiac contractions.
The overdrive pacing method is widely used now in clinical practice for prevention and treatment of severe ventricular disorders of the cardiac rhythm. The mechanisms of arrhythmia suppression by means of this stimulation is analysed. Indications are determined for the choice of the site of stimulation and optimal impulce frequency in ischemic heart disease, and overdosage with digitalis drugs, as well as in myocardiopathy.
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A case is described where the basic sinus rhythms is associated with an advanced degree of left anterior hemiblock. The rhythm is complicated by atrial extrasystoles, associated with a lesser degree of left anterior hemiblock. This paradox of 'supernormality' is explained on a critical interplay of differential refractoriness within the divisions of the left bundle-branch.