In an effort to standardize terminology and criteria for clinical electrocardiography, and as a follow-up of its work on definitions of terms related to cardiac rhythm, an Ad Hoc Working Group established by the World Health Organization and the International Society and Federation of Cardiology reviewed criteria for the diagnosis of conduction disturbances and pre-excitation. Recommendations resulting from these discussions are summarized for the diagnosis of complete and incomplete right and left bundle branch block, left anterior and left posterior fascicular block, nonspecific intraventricular block, Wolff-Parkinson-White syndrome and related pre-excitation patterns. Criteria for intraatrial conduction disturbances are also briefly reviewed. The criteria are described in clinical terms. A concise description of the criteria using formal Boolean logic is given in the Appendix. For the incorporation into computer electrocardiographic analysis programs, the limits of some interval measurements may need to be adjusted.

Background-Mortality from cardiovascular diseases is substantially higher in central and eastern Europe than in the west. After the fall of communism, these countries have undergone radical changes in their political, social, and economic environments but little is known about the impact of these changes on health behaviours or risk factors. Data from the Czech Republic, a country whose mortality rates from cardiovascular diseases are among the highest, were analysed in this report. Objectives-To examine the trends in cardiovascular risk factors in Czech population over the last decade during which a major and sudden change of the political and social system occurred in 1989, and whether the trends differed in relation to age and educational group. Design and setting -Data from three cross sectional surveys conducted in 1985, 1988, and 1992

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The serum selenium levels in 367 healthy adult (25-64 yr) Central Bohemia residents, 176 men and 191 women, were determined using atomic absorption spectrometry. An extremely wide range of values was found in the whole population sample (< 20-296 micrograms/L) as well as in each sex or age category studied. The mean selenium concentration and 95% confidence interval calculated after logarithmic transformation of the data were 74 micrograms/L (71-77) for the whole population sample, 72 micrograms/L (67-76) for men, and 76 micrograms/L (72-81) for women. About 10% of the residents exhibited serum selenium level below 45 micrograms/L. There was no significant correlation between serum selenium and sex, age, or smoking status of participants. However, the lowest average level was found in the group of heavy smoking women: 66 micrograms/L. The selenium status of the Central Bohemia population seems to be below European average. Groups of residents having a very low nutritional selenium intake may be expected to occur in this population.

The population of Czechoslovakia is at high risk of premature atherosclerosis. Normal DNA polymorphism at the low density lipoprotein receptor (LDLR) locus detectable with the restriction enzyme PvuII was analyzed in Czech children with a high or a low concentration of total serum cholesterol. The PvuII restriction site was found significantly more often in the low cholesterol group than in the high cholesterol group. Thus, normal genetic variation at the LDLR locus contributes to the population variation in cholesterol in children in the population studied.

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The mortality rates for the years 1975-1985 for all causes, cardiovascular disease, coronary heart disease and cerebrovascular diseases obtained from the WHO Data Bank in Geneva were analysed separately for men and women in the age group 30-69 years. Data from 30 industrialised countries were available for the analysis. In most of the countries cardiovascular diseases are still responsible for nearly half the deaths in men. The highest mortality rates, except for coronary heart disease, in the age groups studied are in Eastern Europe. Most countries in this region have also registered an increase in the mortality rates during the last decade. This increase is more pronounced in men than in women. The importance of the WHO MONICA Project (Multinational Monitoring of Cardiovascular Disease and Their Determinants) for interpreting these trends is discussed. Information is provided about another WHO project "The Intensified Programme in Coronary Heart Disease Prevention" in which 27 countries are participating. The aim of this project is to facilitate the national action plans for preventing coronary heart disease and exchanging information on their implementation in different countries.