The numerous waves of the right auricular electrokvnmograms of normal subjects are interpreted on the basis of simultaneously recorded electrocardiograms, and jugular and carotid pulse tracings. The factors responsible for shape as well as volume changes of the auricles are discussed. Auricular contractions in patients faith heart block are included to illustrate the isolated dynamic auricular movements.A NUMBER of studies'-6 have been published concerning the movements of the auricles as recorded by the electrokymograph in normal and abnormal conditions. These reports have dealt with the major waves, and thus far no study appears to have been made of the more detailed and finer movements. The interpretation of these is made difficult by the marked variability. Thus, records made from different points of the same auricle of the same subject, or from corresponding points in different subjects, may appear to be very dissimilar. However, there seem to be certain main movements which have been found to be present in all of the subjects thus far studied. The purpose of the present communication is to describe these movements. METHOD OF STUDYObservations have been made on 10 normal subjects, and on two patients with second and third degree heart block. A four-channel direct-writing apparatus has been used to obtain simultaneous records of the electrocardiogram, the carotid pulse, the ballistocardiogram, and the movements of the right auricle. In a number of instances, tracings of the pulsations of the jugular vein have also
A simple method of calibrating the amplitude of the direct ballistocardiogram, utilizing a standard external force to the body, is described. Such a method tends to neutralize many of the variables in apparatus alignment and sensitivity, and provides a basis for comparison of amplitudes in the same and different subjects. Normals of different age groups were studied and the contrast with abnormals with known cardiovascular disease is shown.
With the advent of successful revascularization of blocked and narrowed coronary arteries, using venous bypass grafts from the aorta, the demand for coronary angiography has risen rapidly during the past 5 years. At Harefield 25 arteriograms were performed in 1970 but 615 in 1975 (Fig. 1) though circumstances beyond our control reduced the number conspicuously at the end of the last year. Information about the safety of this examination is, therefore, important. Emanuel (1975) circularized 50 British centres undertaking coronary angiography in 1973. Of the 46 who replied, only 9 knew the mortality rate for their institution; the highest was up to 0-6 per cent. The morbidity ranged from 0 9 to 2-2 per cent. In 1973, Petch, Sutton, and Jefferson reported a series of 400 angiograms with an overall mortality of 1P5 per cent; 2-4 per cent for the 248 done by Judkins' (1967) method and a zero mortality for the 111 by Sones and Shirey's (1962) method. Adams, Fraser, and Abrams (1973), in a nationwide survey of the United States, found a 0-8 per cent mortality for Judkins' technique and a 0 13 per cent mortality for Sones'.The purpose of this paper is to review our experience with particular reference to complications.
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