No abstract

Massive T wave inversion and ST depression occur in the unpaced electrocardiogram subsequent to ventricular pacing, and persist for a varying length of time depending on the duration of pacing. That artificial depolarization of the ventricle causes changes in repolarization which persist after stopping pacing is of considerable theoretical and practical importance, and we describe the findings in 31 patients both with and without disease of the conduction tissue. Thirty-one patients were studied, 11 women, and 20 men, and their ages ranged from 42 to 84 years (mean 67 years): 30 were being paced from the endocardium by transvenous electrode wires, and one from the left ventricular epicardium by epicardial electrodes, all with external units at the time of investigation.Twenty-six patients were paced for chronic atrioventricular (AV) conduction disease with Adams-Stokes attacks. Three were paced after acute myocardial infarcts with temporary disturbance of AV conduction, in order to prevent Adams-Stokes attacks. The VI1 V2

No abstract

No abstract

Sixty-two patients with an isolated late systolic murmur, of whom 33 had a systolic click also, have been followedfor a minimum of 9 years (mean I3 8, maximum 22 years). Most had been known to have a murmur for much longer (mean 27 years, maximum SI years). They were all thought to have mitral regurgitation that was minimal and primary and not secondary to myocardial disease or ischaemic heart disease. Patients were excluded from the series if there were more than minimal left atrial or left ventricular enlargement on x-ray, an abnormal electrocardiogram apart from multiple ventricular ectopics and succeeding flat T waves, or a history of chest pain closely associated with exertion.Four could not be traced but had not been certified as dead at Somerset House, 3 died from irrelevant causes, i diedfrom bacterial endocarditis, and I died ii years later aged 75 from increasing mitral regurgitation.In i patient there was chordal rupture necessitating valve replacement and in I patient bacterial endocarditis caused heart failure.In io patients there was slight deterioration, short of the development of symptoms, over a period averaging II years.