Transient auriculoventricular dissociation with varying ventricular complexes caused by digitalis / Henry A. Christian.

  • Christian, Henry A. (Henry Asbury), 1876-1951
Date:
1915
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Licence: In copyright

Credit: Transient auriculoventricular dissociation with varying ventricular complexes caused by digitalis / Henry A. Christian. Source: Wellcome Collection.

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    decreased, though never came quite to the normal time of transmission. The heart rate increased to 90 on March 26, to 104 on March 27, to 108 on March 28, and to 120 on March 30, and with this increase in rate of contractions the heart remained regular, the complexes normal in form, but the “T” and “P” waves gradually approached nearer and nearer until they became superimposed, which feature was very well shown by some curves taken on March 30, in which, following vagus irritation, there were some greatly increased intervals between successive “R” waves, and during these the “T” and “P” waves became sepa¬ rated (Fig. 6). Fig. 6, Case 1.—Lead II, March 30, 1914. Curve shows a pause caused by vagus pressure. Fig. 7, Case 1.—Lead I, April 3, 1914. The two strips form a continuous curve and the second one is continuous with the curve in Figure 8. On April 2, though still regular, the rate of the heart slowed down to 84, and the “P-R” interval increased slightly in length. On April 3 heart-block again occurred with an auricular rate of 126 and a ventricular rate of 72. In Lead 1 (Figs. 7 and 8) this was present throughout, and at times there was such a pairing of the ventricular beats and changes in ventricular complexes as occurred when the heart was previously in block on March 20 and 21. This block, however, was not maintained, because in the . interval between taking Lead 1 and Lead 2 the ventricular rate increased to 120, the ventricular complexes became normal in form, the “T” and “F” waves coincided (Fig. 9). This condition persisted while Lead 3 was being taken. After Lead 3 was taken, Lead 1 was again taken, and at this time there was an auricular rate of 120 and a ventricular rate of 60, a partial heart-block with 2-1 rhythm. There was a “P-R” interval when transmission was not blocked varying between 0.2 and 0.24 of a second.