Abstract. After conversion of atrial fibrillation right atrium monophasic action potentials have been recorded in 45 patients, using a bedside suction technique. In 30 patients who reached sinus rhythm after DC shock, a good correlation was, found between the duration of monophasic action potential and the sinus rhythm stability during a follow‐up period of six months. In 8 patients still in sinus rhythm after six months and in 15 patients who reached sinus rhythm spontaneously, the duration of monophasic action potential was in the normal range. In 22 patients who relapsed into atrial fibrillation during the follow‐up period, the maintenance of sinus rhythm was closely related with the duration of the monophasic action potential, which was shorter than in stable sinus rhythm. The duration of monophasic action potential after conversion of atrial fibrillation has a prognostic value for the maintenance of sinus rhythm, and when its duration is short a conservative treatment instead of repeated DC shocks may be considered.

A simple bedside technique utilizing a suction electrode allows the recording of monophasic action potential (MAP) from the intact human heart. An analysis of the right atrium MAP in patients with various arrhythmias suggests that its duration provides a useful index of myocardial refractoriness. Short MAP after conversion of arrhythmias may indicate the instability of the sinus rhythm. In the same way, it is possible to predict the maintenance of the sinus rhythm after DC shock. MAP recording provides an interesting method for analysis of the electrical events during atrial arrhythmias: atrial flutter and fibrillation, supra-ventricular tachycardias and premature beats.

This report describes the case of a patient with a supraventricular tachycardia with a ventricular rate of 109/1mn and no visible P waves in the electrocardiogram. The recording of the monophasic action potential of the right atrium disclosed an atrial tachycardia with a rate of 218/min. There was an alternans of the phase 2 of repolarisation in the action potential. This report emphasises the fact that the phenomenon of alternans occurs in man, as in the experimental animal, at a cellular level.

Purpose The purpose of this paper is to offer a Christian perspective on the ethical issues related to natural procreation and artificial reproduction methods. Design/methodology/approach This paper uses descriptive and comparative methodology between the ethical aspects specific to natural procreation and artificial reproduction. Findings Religious beliefs play a significant role in shaping the moral perspective when an infertile couple is confronted with the choice between natural procreation and artificial reproduction. Originality/value This paper survey a broad bibliography and offers a critical evaluation of the moral aspects specific to different methods of reproductive technologies compared to the natural procreation approach.