There was a significant slowing of local conduction in the LVZ defined as <0.5 mV and was frequently associated with fractionated or double potentials in patients with AF.

on behalf of the J-RHYTHM Registry Investigators* Background--To clarify the influence of hypertension and blood pressure (BP) control on thromboembolism and major hemorrhage in patients with nonvalvular atrial fibrillation, a post hoc analysis of the J-RHYTHM Registry was performed.

SUMMARY Five cases with a sudden onset of dysarthria in the setting of hypertension are presented. No case had limb weakness or other neurological deficits. Computed tomographic scan demonstrated a small low density lesion in the anterior part of the internal capsule or the adjacent corona radiata. All cases showed a good recovery from dysarthria within two to four weeks.Since computed tomographic scan (CT scan) was introduced, small infarcts have attracted the interest of many neurologists, for the various symptoms produced. In a recent review, Fisher' summarised the lacunar syndromes; however, the site of the lesion responsible for the pure dysarthria syndrome, one of the lacunar syndromes he originally described, remains uncertain. In this report, we present five cases with pure dysarthria, in which a small low density lesion was demonstrated by CT scan. In all instances, the lesion was in the anterior part of the internal capsule or the adjacent corona radiata. Case reportsCase I A right-handed 52 year old man with untreated hypertension for one year, presented on 1 May 1984, because he had had difficulty in speaking since 29 April. On examination his blood pressure was 170/1 10 mm Hg; he had impaired articulation with slurred speech with nasal features, but no dysphagia. Weakness of the tongue was not detected. Soft palate movements were well preserved. No facial palsy. There was neither weakness nor ataxia in his limb movements. Tendon reflexes were normal and symmetrical. Plantar responses were flexor; however, the left palmomental reflex was positive. CT scan performed on 7 May, 9 days after the onset, revealed a small low density area at the right genu of the Address for reprint requests: Dr I Ozaki, Third

Our results suggest that CPAP plus pressure support is more effective than simple CPAP in heart failure patients and that the enhancement might be induced by neural changes and not simply by alteration of the preload level.

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