Complete heart block and left bundle branch block in valvular heart disease

147

-4bstracts method heart

for studying

the effects

in a preparation

of digitalis

devoid

upon the

of peripheral

effects

It

of the drug. Complete

Heart

Block

Valvular

in

RORERTS, M.D.? ANDREW

bundle

Block

branch,

neoplasms,

and block

heart

CHB

and 9. chronic congenital

unicuspid

LBBB.

aortic

valves,

disease

with

sections

of the A-V

involvement

The

study or

conduction

in

can

that

usually

A graph

arterial

M.D.,

pressure

nodules.

be

found in

cause

when

patients

of

autopsy

been

have

and

pressure

(Korotkoff)

(sphygmorecording) with congenital

heart disease

studied.

The

sounds

high,

arteriosus

or in the septal

muscular muscular

upstroke

in

stenosis

documented Surgical

The

and

septal abnormal

in other repair

immediately

VOLUME 19, JANUARY 1967

and/or appeared

patent

ductus

hypertrophy

of

of Fallot,

sounds

were de-

on the foot of the defect

(28

timing

have

forms of congenital

of the foregoing by normal

cases). also heart

conditions

timing

of the

new,

of

useful

dynamics

of Diphenylhydantoin of Awake

ROBERT

Dogs,

reviews have called

arrhythmias,

(DPH)

intoxication.

examine

the electrophysiologic

heart

of awake

This

dogs.

mg./kg.

weeks

study

rate, shortened little

of conduction

ventricular

effects were noted when heart Following

the threshold

with no change block

had

been

DPH

DPH

block

crease

S&&cans System,

ectopic

the major

rate.

actions

A-V

of

conduc-

(2) raise the threshold

response

muscle,

for

f’3j de-

rate of the atrium pacemaker

and

activity.

to form a reasonable

basis for

of diphenylhydantoin.

of Lungs ARTHUR

with a 5inch A.

Dual

SASAHARA,

M.D.,

JOHN S. BELKO, MS. and ROBERT G. SIMP-

SON, West Roxbury With

emphasis

embolism, which

mg./‘kg.

the

ventricular

and ventricular

appear

Detector

(0.16

abolished

that

action,

to stimulaautomaticity

are to (1) facilitate

effectiveness

Blended F.A.c.c.,

ventricular

digitalis-induced

actions

respond

the control

suggest

of atria1

the clinical

the maximal

DPH

the maximal

These

In dogs with

by deslanoside

and restored

abolish

periods. markedly

would

after

enhanced

tion by a vagolytic

denrrvation, muscle

the atrium

on the heart

rate was con-

of atria1 and ventricular decreased

findings

in

time.

conduction.

intravenously),

tachycardia

A-V

of

velocity

cardiac

of refractory

DPH

In heart

given

shorten

(10

activation

by pacing.

raised

DPH an increase

time and pro-

trolled

to

elec-

node, bundle

recovery.

Similar

failed

to

on the

recording

conduction

or no change

tissue or total

DPH

designed

of DPH

produced

A-V

of

from

and studies performed

following

given intravenously)

Purkinje

was

effects

branch

to the

resulting

on the sinoatrial

of His and right bundle to four

those

Intracardiac

trodes were implanted one

attention

for the treatment

especially

digitalis

(4)

stroke out-

(tetralogy

was present

ventricular

patterns

was followed

as in widely

stenosis).

and a plateau

which

recordings.

surgery

recent

excitation

with intra-arterial

put was abnormally

subaortic

calibrated

when left ventricular

(12 cases)

of

sounds in each

a timed,

catheterization,

than normal

subvalvular

Several

rate at which

the time

Effects

use of diphenylhydantoin

with

S.

technic

offers

N. C.

heart

Disease,

innocuous

ventriculo-aortic

on the Heart

these

KATHERINE

against

provides

than 100 patients

earlier

Heart

all the sounds

ROSATI, B.S. and ANDREW G. WALLACE, M.D., Durham,

These

tracing

identical by

been

calcium

an anatomic

F.A.c.c.,

cycle

documented

diseasr.

with

Calif.

cardiac

is essentially

Specific

either

in Congenital

of the arterial

successive

(Dilantin)

duced

destruction

in the 9 subjects

by

occur

of the cuff

occurrence

heart disease.

tion.

Patterns Duarte,

concerning

heart

heart disease.

M.D..

layed.

Serial

in the 4 patients

its course

indicates

SIMON RODBARD,

More

complete

was intact

disturbances

Korotkoff BAO:

cardiac

and proximal

tissue or rheumatoid

LBBB

valvular

and aortic

valves.

bundle

deposits

bundle

early fibrous

This CHB

mitral

or

but in each the left bundle was completely

interrupted deposits,

A-V

disclosed

A-V

with LBBB.

bicuspid

rheumatoid

of all four

node,

branches

of these subjects

with

1 had

of the node by calcium CHB.

Eight

stenosis

and

life 4 had had

the

sounds

in congenital

may

bundle

of patients who died

4 had rheumatic

disease,

bundle

foci

or left

During

disease.

that

arterial

information

cardiac

valvular

valvular

tis-

nodules,

(LBBB).

had

is concluded the

failure.

delayed.

Electrophysiologic (A-V)

fibrous

infective

(CHB)

7 his study reviews 246 autopsies of cardiac

and

Md.

rheumatoid

and

block

C.

M.D.

With advent of cardiac

recording

Branch

WILLIAM

including

sarcoid,

inflammatory

complete

branch

Bundle

into the atrioventricular

or left bundle

amyloid

Left

Disease,

LOUIS D. WRIGHT,

F.A.c.c.,

infiltrations

sue, calcium, cause

and

Heart

MORROW, M.D., Bethesda,

G.

Various

sounds.

were progressively

and Boston, on early

diagnostic

Mass.

diagnosis

methods

have

are safe, easy and quick

procedure

may

be

of pulmonary been

to perform.

intravenous

sought. Such

radioisotope

a

lung

scanning. Conventional anterior

1’31 methods

or posterior

of scanning

lung require

either

the

30 to 40 minutes.