Abstract It is stated that the effect of digitalis on the heart can simulate almost every type of electrocardiographic abnormality due to cardiac disorders with the exception of intraventricular conduction defects.1 As far as the normal electrocardiogram is concerned, this statement is undoubtedly true. The observations of Hart,2 however, have been widely cited in the literature as indicating that digitalis may occasionally cause a delay in intraventricular conduction and a consequent widening of the QRS complex. In this study prolongation of the QRS time was produced by digitalis in the course of a clinical experiment. The observations were made in a case of so-called "bundle branch block with short PR interval," a syndrome first observed by Wilson3 and subsequently described by Wolff, Parkinson and White.4 Bishop5 more recently reviewed 45 cases of this syndrome reported in the literature, but as far as we are able to References 1. Goodman, L., and Gilman, A.: The Pharmacological Basis of Therapeutics , New York, The Macmillan Company, 1941, p. 518. 2. Hart, T. S.: Block of the Branches of the Bundle of His , Arch. Int. Med. 35:115 ( (Jan.) ) 1925.Crossref 3. Wilson, F. N.: A Case in Which the Vagus Influenced the Form of the Ventricular Complex of the Electrocardiogram. Arch. Int. Med. 16:1008 ( (Dec.) ) 1915.Crossref 4. Wolff, L.; Parkinson, J., and White, P. D.: Bundle-Branch Block with Short P-R Interval in Healthy Young People Prone to Paroxysmal Tachycardia , Am. Heart J. 5:685 ( (Aug.) ) 1930.Crossref 5. Bishop, L. F.: Bundle Branch Block with Short P-R Interval in Individuals Without Organic Heart Disease , Am. J. M. Sc. 194:794 ( (Dec.) ) 1937.Crossref 6. Cheer, S. N., and Dieuaide, F. R.: Studies on the Electrical Systole ("Q-T" Interval) of the Heart: IV. The Effect of Digitalis on Its Duration in Cardiac Failure , J. Clin. Investigation 11:1241 ( (Nov.) ) 1932.Crossref 7. Wilson, F. N.: The Production of Atrioventricular Rhythm in Man After the Administration of Atropine , Arch. Int. Med. 16:989 ( (Dec.) ) 1915.Crossref 8. Katz, L. N.: Electrocardiography , Philadelphia, Lea & Febiger, 1941, p. 524. 9. Wolferth, C. C., and Wood, F. C.: The Mechanism of Production of Short P-R Intervals and Prolonged QRS Complexes in Patients with Presumably Undamaged Hearts: Hypothesis of an Accessory Pathway of Auriculoventricular Conduction (Bundle of Kent) , Am. Heart J. 8:297 ( (Feb.) ) 1933Crossref 10. Further Observations on the Production of a Short P-R Interval in Association with Prolongation of the QRS Complex , Wolferth Am. Heart J. 22:450 ( (Oct.) ) 1941Crossref 11. Kent, A. F. S.: Some Problems in Cardiac Physiology , Brit. M. J. 2:105 ( (July 18) ) 1914.Crossref 12. Butterworth, J. S.: The Experimental Production of the Syndrome of Apparent Bundle Branch Block with Short P-R Interval , J. Clin. Investigation 20:458 ( (July) ) 1941. 13. Scherf, D., and Schönbrunner, E.: Beiträge zum Problem der verkürzten Vorhofkammerleitung , Ztschr. f. klin. Med. 128:750, 1935. 14. Winternitz, M.: Die Digitaliswirkung auf das menschliche Kammerelektrogramm , Ztschr. f. Kreislaufforsch. 23:452, 1931. 15. Hering, H. E.: Experimentelle Studien am Säugetieren über das Elektrokardiogramm , Arch. f. d. ges. Physiol. 127:155, 1909.Crossref 16. Einthoven, W.: Le télécardiogramme , Arch. internat. de physiol. 4:132, 1906. 17. Ritchie, W. T.: The Action of the Vagus on the Human Heart , Quart. J. Med. 6:47 ( (Oct.) ) 1912. 18. Starr, I., Jr.: A Note on the Antagonism Between the Cardiac Action of Acetyl-β-Methylcholine and Acetyl Choline, and That of Quinidine , J. Pharmacol. & Exper. Therap. 56:77 ( (Jan.) ) 1936. 19. Butterworth, J. S., and Poindexter, C. A.: Short PR Interval Associated with a Prolonged QRS Complex , Arch. Int. Med. 69:437 ( (March) ) 1942.
Archives of Internal Medicine – American Medical Association
Published: Feb 1, 1943