[Ventricular pre-excitation disclosed by an episode of high-frequency atrial fibrillation: the role of frequency-dependent variations in the bundle of Kent conduction]. / Preeccitazione ventricolare svelata da un accesso di fibrillazione atriale ad alta frequenza: ruolo delle variazioni frequenza-dipendenti della conduzione nel fascio di Kent.

The presence of a ventricular pre-excitation, which becomes evident only during episodes of atrial fibrillation, is a very rare event. The authors report a case of ventricular pre-excitation revealed by an access of atrial fibrillation with high ventricular frequency and hemodynamic failure. The ventricular pre-excitation signs were not evident after the sinus rythm had been restored. The electrophysiological study has shown that such behaviour is not related to a different input of the stimulus in the bypass tract during the passage from the sinus rhythm to the atrial fibrillation, as other authors have recently suggested, but to rate-dependent variations of the conduction in the Kent bundle: in the bypass either a phase-4 block of the conduction is present, or a supernormal conduction.

[Emergency heart stimulation with a transthoracic electrode. Our experience in 35 cases]. / La stimolazione cardiaca d'urgenza con elettrodo transtoracico. Nostra esperienza in 35 casi.

35 cases of heart stimulation using a transthoracic electrode are presented. It is emphasised that the technique is only applicable in very few cases (total AVB with a critical frequency below 20/min, all types of asystolia). The simple technique, results and complications (in theory many but in practice only 1 occurred) are briefly described.

[Emergency transfer of cardiac patients. The extent of the problem in the first 5 years of activity of the Imperia Hospital's Cardiology Department]. / Il trasferimento urgente del malato cardiopatico. Dimensioni del problema nei primi 5 anni di attività della Sezione di Cardiologia dell'Ospedale di Imperia.

An account is offered of urgent transfers of patients carried out by the Imperia Hospital's cardiology section in a period of 5 yr. Frequency (1.5% of admitted patients), destination (63% to Genoa, the regional capital), modality (Red Cross ambulance in all but one case), and form of accompaniment (doctor or trained attendant in 81%) are described along with the reasons for the transfer. Of these, 73% were AV block with MAS. It is felt, if the section can be equipped in the future for the installation of permanent pacemakers, the number of such transfers could be cut down to a few cases per year.

[Recurrent bradysystolic arrhythmia caused by closed thoracic trauma]. / Bradisistolia ricorrente per traumatismo toracico chiuso.

A case of slight thoracic trauma, part of more serious traumatism of the pelvis which developed a rare form of recurrent bradysystolia due to progressive slowdown of the sinus-atrial node, is reported. Emergency treatment with temporary i.v. electric stimulation allowed the patient to surmount the crisis and complete cure has now been evident for 8 months.

[The organization of diagnostic exercise tests in a provincial general hospital]. / L'organizzazione delle prove da sforzo diagnostiche in un ospedale generale provinciale.

The approach to the diagnostic effort test recently recommended by the A.N.M.C.O. is discussed. The cost of equipment and staff required are examined. Precise data regarding the cost of such a unit in the cardiology department are given and stress is laid on the advisability of confining its use to cases in which clinico-historical investigation and preliminary clinical evaluation point to it as indispensable for cardiology diagnosis.

[Atrial electric stimulation via the esophagus. A promising new method]. / La stimolazione elettrica atriale per via esofagea.

Experience acquired in the electrical stimulation of the atrium via the oesophagus in 18 consecutive cases ir presented. An account is given of the technique and the results obtained. These confirm the reliability and simplicity of execution of the entire diagnostic procedure.

[Myocardial infarct. Dimensions of the problem and its local aspects]. / Infarto del miocardio. Dimensioni del problema e suoi aspetti locali

World statistics of infarction are given in brief from the viewpoints of incidence, mortality and prevalence. The results of analysing admittances for m.i. to the Imperia Hospital in the period 1960-1972 are then reported. The series is considered from the general and local standpoints, with reference to the organizational and welfare problems created by the high number of admittances and their high annual increment.

[Difficulties in the electrocardiographic diagnosis of a previous posterior myocardial infarct]. / Difficoltà nella diagnosi elettrocardiografica di pregresso infarto miocardico "posteriore"

A retrospective study was carried out of 39 cases of posterior m.i. from 8 months to 6 years after acute episode. In each case the diagnostic reliability of the standard derivations of a series of parameters was evaluated (duration of Q D3 and Q aVF, Q.100/R ratio in aVF, R/S ratio in V1 and R V1/R V6) and of the following accessory derivations: De Maria, III P of Pescador (classical and in two personal modifications), dorsal and sternal derivations. It is concluded that in many cases, standard derivations do not enable previous posterior m.i. to be diagnosed. The De Maria and III P of Pescador derivations (with the proposed personal modifications) are advisable. In isolated cases, the sternal derivation may also be very useful.