A patient is presented in whom the heart reverted spontaneously to sinus rhythm 11 years after surgical closure of a ventricular septal defect complicated by complete heart block. It seems unlikely that regeneration of fibres in the bundle of His, if these had indeed been destroyed, could account for the restoration of sinus rhythm after so long an interval.

We describe an uncommon case of typical flutter with symptomatic sinus node dysfunction, in which a permanent junctional rhythm developed following ablation of the cavo-tricuspid isthmus. This rhythm activated the right atrium in counter clockwise manner thus providing spontaneous proof of unidirectional isthmus block, a phenomenon that is usually demonstrated by proximal coronary sinus pacing.

A new neural network system for classification of the cardiac rhythm is presented in this paper. The system is composed of two neural network classifiers : a morphological classifier cascaded to a timing classifier. While the morphological classifier classify the P and QRS complexes into normal and/or abnormal beats, the timing classifier takes as inputs the information of the morphological cla...

Severe hypertension was seen in a patient with mitral stenosis when in sinus rhythm. A large fall in systolic blood pressure and in left ventricular end-diastolic pressure was caused by ventricular pacing. Contrary to the usual situation in mitral stenosis this patient paradoxically is a subject who improved haemodynamically with the loss of sinus rhythm and of atrial systole.

BACKGROUND AND PURPOSE Thromboembolism in paroxysmal atrial fibrillation (AF) has often been attributed to occult AF. We hypothesized that the surface ECG may not always reflect left atrial appendage (LAA) mechanical function. METHODS Transesophageal echocardiographic images from 201 consecutive patients undergoing transesophageal echocardiography by a single operator were reviewed. LAA pulse...

OBJECTIVE To evaluate prospectively the effects of pretreatment with verapamil on the maintenance of sinus rhythm after direct current (DC) cardioversion. DESIGN Randomised, active control, open label, parallel group comparison of verapamil versus digoxin. SETTINGS Multicentre study in three teaching and three non-teaching hospitals in Sweden. PATIENTS 100 consecutive patients with atrial...

SINUS bradyeardia has been associated with a number of entities, both normal and pathologic; however, it is usually of a transient nature. It has been found in 30 per cent of healthy young males,' the well-trained athlete,2 and has been associated with pregnancy, particularly the post partum period.3 Its incidence markedly exceeds what might be expected in starvation, myxedema, jaundice, increa...

Objective: To evaluate prospectively the effects of pretreatment with verapamil on the maintenance of sinus rhythm after direct current (DC) cardioversion. Design: Randomised, active control, open label, parallel group comparison of verapamil versus digoxin. Settings: Multicentre study in three teaching and three non-teaching hospitals in Sweden. Patients: 100 consecutive patients with atrial f...

OBJECTIVES The purpose of this study was to analyze the effect of beta blockade on outcome in patients with heart failure (HF) and atrial fibrillation (AF). BACKGROUND Beta-blockers are widely used in patients with HF and AF. Recommendation in current HF guidelines, however, is based on populations in which the most patients had sinus rhythm. Whether beta-blockers are as useful in AF is uncer...

OBJECTIVES Our purpose was to assess the risk factors for late mortality, loss of sinus rhythm and atrial flutter after the Mustard operation. BACKGROUND The Mustard operation provides correction of cyanosis with low surgical risk in transposition of the great vessels. However, right ventricular failure, loss of sinus rhythm, atrial flutter and death are frequent long-term complications. ME...