Abstract A cardiac rhythm arising in the atrioventricular junctional tissues in the human is a rare and usually very transient affection, so uncommon in fact that it has never been the object of careful investigation. Premature beats and paroxysms of tachycardia having their origin in the junctional tissues have been reported frequently. Belski1 in 1909 wrote of six cases of acute infectious disease in which polygrams seemed to indicate that the bradycardia was not infrequently due to an atrioventricular rhythm. In one case the subcutaneous injection of atropin sulphate, gram 0.001, produced in twenty minutes an acceleration of the pulse from 42 to 137, while the rhythm apparently changed from one arising in the atrioventricular junctional tissues to one of the normal sino-auricular type. Five hours after the atropin had been given the pulse had dropped to 55 and the rhythm was still normal. The next day at References 1. Belski, A.: Ztschr. f. klin. Med. , lxvii, 1909. 2. Williams, H. B., and James, H. : Heart , 1914, v. 3. Hume, W. E.: Heart , 1913, v. 4. Lewis, Th.: Heart , 1913-1914, v. 5. Lewis, Th., White, P. D., and Meakins, J.: Heart , 1914, v. 6. April 12, 1915, the rhythm was continuing unchanged, ten weeks after its onset. He was examined frequently in this period. May 11, 1915, the patient again showed auricular flutter by electrocardiogram, with an auricular rate of 300 and an irregular ventricular response at a rate of 100 per minute. The patient observed a sudden change in his pulse from a slow, regular rate to an irregular and much more rapid rate on the 10th of May, the day before the electrocardiogram above noted was taken, and fourteen weeks after the onset of the atrioventricular rhythm. May 18 an electrocardiogram showed again the atrioventricular rhythm restored through the administration of 1.8 grams of digitalis leaves in the course of a week. A bigeminy similar to that previously described was present. 7. Cohn, A. E., and Fraser, F. R.: Heart , 1914, v. 8. Lewis, Th.: Heart , 1914, v. 9. Lewis, Th., and White, P. D. : Heart , 1914, v, 359.
Archives of Internal Medicine – American Medical Association
Published: Oct 1, 1915
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