Frequent Extrasystoles Research Articles

Measuring ventricular extrasystoles

Uniform ventricular extrasystoles can be divided into three types: fixed coupling, parasystole, and variable non-parasystolic coupling. Frequency distributions of coupling intervals of ventricular extrasystoles were determined from long electrocardiographic recordings of 51 patients with variable coupling. These distributions were of five types: (a) two distinct coupling intervals, (b) a preponderance of extrasystoles with short coupling intervals and less frequent extrasystoles with progressively longer coupling, (c) a preponderance of long coupling intervals and less frequent extrasystoles with progressively shorter coupling, (d) an even distribution and (3) a central distribution. Interectopic intervals were measured in these electrocardiograms (ECGs). Parasystole was found only in three recordings. It is recommended that the diagnosis of parasystole be made only if the degree of variation of the ectopic cycle (both when it is manifest and when it is concealed) is less than the variation of the coupling intervals. When the ECGs with variable non-parasystolic coupling were compared with 44 ECGs with fixed coupling, it was found that variable coupling was associated with abnormalities of the basic electrocardiographic contour, multiformity of extrasystoles and repetitive extrasystoles.

Transient cardiac arrhythmia induced by nonpenetrating trauma to the chest

1. 1. Transient cardiac arrhythmia induced by nonpenetrating trauma to the chest has been reported only rarely, an extensive review of the literature revealing only 17 cases followed by apparently complete recovery. It is quite probable that the reported cases represent only a fraction of the true incidence and that increasing awareness of the possibility coupled with more common use of the electrocardiograph will detect cases more frequently. 2. 2. The available literature does not lend itself to statistical analysis, but approximately two-thirds of the reported instances of cardiac arrhythmia in traumatic heart disease were associated with other demonstrable permanent cardiac lesions, and in a number of cases, with death. Therefore, the presence of cardiac arrhythmia in nonpenetrating chest trauma must not be regarded lightly. 3. 3. It seems most likely that the transient arrhythmias are due to contusion of the right auricle in the region of the conduction system, being occasioned by compression of the heart against the liver at the right pericardiophrenic angle. 4. 4. A case of transient auricular fibrillation and one of transient supraventricular tachycardia due to nonpenetrating chest trauma in young men without antecedent history of heart disease are presented. Also reported is a case of frequent auricular extrasystoles due to chest trauma in an elderly man who had asymptomatic arteriosclerotic heart disease. In each instance, as far as could be determined clinically, there was no evidence of permanent cardiac injury.

Effect on the heart of an overdose of epinephrine: Report of a case

A naval aviator was inadvertently given an injection of 5.0 c.c. of a 1:1000 solution of epinephrine hydrochloride. The arrhythmia noted in the first thirty minutes could have been due to frequent extrasystoles or to transient ventricular fibrillation. The precordial distress, the transient elevation of temperature, the increase of sedimentation rate, and the prolonged electrocardiographic changes could have been due to actual infarction of the myocardium. The evidence in this case indicates that epinephrine in large doses causes relative coronary insufficiency in the normal adult.