[Value of potassium canrenoate in the prevention of arrhythmia during the acute phase of myocardial infarction].

This study was based on a series of 486 patients with acute myocardial infarction. All were treated with heparin and nitrite derivatives. 320 patients received 600 mg/24 h Potassium Canrenoate for 5 days (long duration); 90 patients received 1000 mg of Potassium for the first 36 hours only.

[Improvement and normalisation of the QRS complex by stimulation of the bundle of His in complete left branch block].

The asynchronism of ventricular activation resulting from a major degree of left bundle branch block (QRS greater than or equal to 0.12 s) may be suppressed by stimulation of the distal portion of the His Bundle, whether the block be intermittent (3 cases) or permanent (17 cases). The selective stimulation of the His Bundle normalises ventricular depolarisation whilst non-selective stimulation narrows the QRS complex by the fusion of the activation wave fronts from the His Bundle and the interventricular septum.

[Value of continous 12-hour electrocardiography during the rehabilitation period in patients convalescing from myocardial infarction. Apropos of 40 cases].

The results of continuous 12-hour electrocardiography in 40 convalescent patients after myocardial infarction undergoing a programme of readaptation on average 4 weeks after the initial infarction are reported. The frequency and alarming nature of the VES observed in 75% patients who had already undergone selection for the coronary readaptation programme, 30% of whom were receiving antiarrhythmic therapy, is emphasized. The observation of a progressive increase in the number of VES during the day prompts the following suggestions: the possibility of limited continuous ECG monitoring at the end of the day, the need to adapt the dosage of antiarrhythmic drugs during this most critical period.

[Electrophysiological effects of the combined administration of digoxin and propranolol in man].

The electrophysiological effects of the combined administration of digoxin and propranolol were studied in 40 patients, compared with the effects of digoxin alone and considered in relation to anomalies of the conduction pathways. The cycle of the sinus node was only lengthened by digoxin in patients who had an anomaly of sinus node function. In contrast the addition of propranolol always increased it (from 1 109 +/- 53 ms to 1 232 +/- 58 ms).

The dependence of T wave alternans on diastolic resting period duration.

The dependence of T-wave alternans on diastolic resting period duration as well as on regional differences in monophasic action potential duration was studied in the in situ dog heart. T-wave alternans was elicited when diastolic resting period shortened to values less than 41 +/- 6% of the cardiac cycle. This could be attained either by increasing the driving rate, or lengthening action potential duration by inducing hypocalcemia.

[The supernormal phase of cardiac conduction. An experimental study in the dog].

The existence of a cardiac phase of supernormal excitability is not fully proved at the cellular level. As far as the whole heart is concerned, the phenomenon of supernormal conduction is still under discussion. Intracardiac conduction has been studied both in the right atrium (13 dogs) and in the right ventricle (14 dogs) by programmed stimulation (extrastimulus technique), while monophasic action potential (MAP) was recorded.

[Carcinoid heart disease secondary to a tumor of the small intestine. Apropos of a case with associated tricuspid and pulmonary insufficiency].

The authors report a case of carcinoid heart disease secondary to a tumour of the small bowel with liver metastases. There were severe lesions of the endocardium on the right side of the heart, with gross pulmonary and tricuspid incompetence. The left side of the heart did not escape but the fibrous plaques were limited to the papillary muscle of the mitral valve, and had no effect upon the haemodynamics.

[Diagnosis of posterior infarction. Value of vectorcardiography. Apropos of 108 cases, 31 of which had exclusively posterior necrosis].

An analysis of the vectorcardiogram results (VCG) in 77 cases with a posterior extension of an infarct and 31 cases with an exclusively posterior infarction (EPI) has allowed us to distinguish some diagnostic criteria relative to the extension, or localisation, of an infarct in the posterior segment. The maximum anterior vector (MAV) appears late (36.5 ms +/- 5), and the amplitude of its projection onto Z is increased; the maximum vector (V max) appears early (41.

[Dromotropic effects of drug combinations. Initial results bearing on a combination of deslanoside and ajmaline].

The electrophysiological effects of the cardiotropic drugs have been studied in man by the agency of endocavitary electrocardiography. The effects of drug combinations, which are often prescribed therapeutically, have been studied less often. The authors report the results of a preliminary study of the combination of deslanoside with ajmaline in 26 patients; its effects were compared with those using each drug separately.

[The heart and lithium. Apropos of a case of lithium poisoning with intracavitary electrocardiographic exploration].

Among the secondary effects of the salts of Li+, which are widely used in psychiatric treatment, cardiac toxicity appears to be rare. The authors report the case history of a female of 24 years of age, with no previous cardiac history, who presented with Li+ intoxication and a supra-His atrio-ventricular block, followed by episodes of sinus arrest (or of sino-atrial block), accompanied by either a junctional rhythm or by periods of prolonged asystole. The results of the endocavitary electrocardiographic investigation are described.

[Association of progressive external ophthalmoplegia and myocardiopathy with complete atrioventricular block. Apropos of a new case].

The authors report the case of a 31 year old man with an occulomotor palsy, who was admitted to hospital with complete atrio-ventricular block and syncopal attacks. The possible pathogenic significance of this association has given rise to differing hypotheses. A review of the literature shows that the occulomotor palsy has been interpreted either as an ophtalmoplegia (of neurogenic origin) because of the associated neurological findings and the histological changes in the occulomotor nuclei, or as an occular myopathy because of the associated muscular disorders and the changes on electromyography and on histology.