The ballistocardiographic pattern, with special reference to the H-wave

656

AMERICAN

THE

BALLISTOCARDIOGRAPHIC PATTERN, WITH ERENCE TO THE H-WAVE.-JOHN L. NICKERSON, N. Y.

HEARTJOURNAL

SPECIAL M.D., NED

REFYORK,

The origin of the various portions of the ballistocardiographic pattern is demonstrated by the use both of models and of clinical material. One serious objection to the model method of testing different circulatory situations has been that fluid ejection in the model produces immediate movements of the ballistic system, whereas with human ventricular ejection the movement of the ballistic system appears to be delayed by .02 to .03 second. In the work presented here we have been fortunate in obtaining records where the auricular and ventricular patterns were sufficiently separated so that the effect of the auricular complex in causing this apparent delay was revealed. A CLASSIFICATION

OF CONGENITAL CARDIAC UPON HEMODYNAMIC PRINCIPLES: ITS CLINICAL DIAGNOSIS.-SERGIO NOVELO, M.D., M.D.,

MEXICO,

DISEASES USEFULNESS AND RODOLFO

BASED FOR I;IM~N,

D.F., MEXICO

It is considered that the alteration of circulatory dynamics in congenital cardiac cases is fundamentally responsible for the clinical and pathological findings. Regardless of the wide variety of anatomical types, the end result of the morphological defects is the creation of several circulatory patterns. Clinically speaking, it is not always possible to recognize the exact anatomical nature of circulatory alteration in most of the cases. Furthermore, surgery is able to correct or alleviate the altered circulation, either by surpressing anatomical defects or by creating compensatory mechanisms. Thus, in the present state of knowledge, what the clinician should accomplish is to individualize the patient’s circulatory pattern and to ascertain if it is amenable to surgical correction. These facts stress the necessity of grouping congenital malformations of the heart within hemodynamic patterns. We believe that a classification of this sort will be useful in clinical work. The authors present their own classification. FIJRTHER STUDIES OF THE ERYTHROCYTES.-GUSTAV

CIRCULATION NYLIN, M.D.,

WITH AND

RADIOACTIVE

S. HEDLIJND,

M.D.,

STOCKHOLM,SWEDEN.

Published in full in this issue. MECHANISM

IN

ALTERNANS.-RICHARD

WENCKEBACH’S F. OHNELL,

PERIODS AND M.D., STOCKHOLM,

ELECTRICAL SWEDEN.

Earlier studies regarding the mechanism in these conditions have emphasized the significance of insufficiency recovery from one beat to the other. ijhnell and Anderson, 1946, and Ohnell, 1946, have reported cases where autonomic inhibitory effects seemed to dominate the picture in certain cases of Wenckebach periods. Periodicity was related to respiratory movements. The intimate connection with respiration has been further elucidated. Increased respiratory frequency gives fewer conducted beats per period. For a short while before the spontaneous disappearance of the periodicity, one period configuration of single periods may occur at every other breath. “Aberrant” may be explained by altered length of the respiratory cycles, and so forth. As an explanation of this phenomenon, it is assumed that varying autonomic Furthermore, some mechanism or o&her activity inhibits the A-V conduction. will cause a return to a normal P-R interval after every dropped ventricular