Unusual cardiac arrhythmias in a patient recovering from shop typhus

Abstract

Unusual cardiac arrhythmias are described which were observed in a 17-year-old Javanese boy who was recovering from shop typhus. Among the arrhythmias analyzed are instances of S-A block (Figs. 4, 5, and 6), intermittent dissociation (Fig. 8), an unusual form of complete A-V dissociation (Figs. 9 and 10), pseudoreciprocal rhythm and intermittent dissociation (Fig. 11), and dominant atrionodal rhythm with ventricular bigeminy and an intervening P wave (Fig. 12). Unusual forms of ventricular bigeminy are shown in Figs. 7, 10, and 12. In the many records of this patient, taken during a period of many months, the rhythm-producing function was almost never located in the normal pacemaker of the heart. Usually, centers in the lower part of the S-A node and the A-V node controlled the heart. However, the function of these centers was seriously affected also.