[Interventricular communication, aneurysm of the membranous septum and acquired atrioventricular block]. / Communication inter-ventriculaire, anévrysme du septum membraneux et bloc auriculo-ventriculaire acquis

Over a ten year period of a man 40 had a progressively increasing atrioventricular conduction defect, resulting from a ventricular septal defect with eventual cardlac failure due to persistant bradycardia. Intracavitary recordings showed the block to be situated distally, below the bundle of His. Cineaarteriography, and subsequent operation, showed an aneurysm of the membranous septum lying above a fibrous-edged ventricular septal defect. The aetiology of the block is discussed in the light of these defects; Haemodynamic trauma to the conduction pathways exposed in the inferior edge of the septal defect seems to be the most likely cause.

[Recording and data processing of electrical signals of the specific atrioventricular conduction pathways in man]. / Recueil et traitement des signaux d'activité électrique des voies de conduction spécifiques auriculo-ventriculaires chez l'homme.

Signals of the electrical activity of the specific atrioventricular conduction pathways were recorded with an unipolar lead to obtain an exact time reference. The amplifier used had special characteristics: high gain settings (up to 300,000), very low noise levels, and wide filter range (2 Hz - 1,600 Hz). The low amplitude of the signals under study, of the order of a microvolt, and the wide filter range of the amplifier necessitated placing the patient in a Faraday cage. The signals recorded on magnetic tape were treated by a system of analysis for signal treatment. The method of averaging was used to extract the signal from background noise especially that arising from somatic muscle. The amplitude of the Hisian signal was much larger than that usually obtained with other methods. The intervals were determined with precision of the order of 1 millisecond. Frequential analysis of the signals gave another representation of the information contained in the time signals. This new representation seems to give better discrimination of the different zones of activation of the specific atrioventricular conduction pathways.

[Registry of heart failure patients hospitalized in 2000. Data from the National College of Cardiology and General Hospital]. / Registre des insufisants cardiaques hospitalisés en 2000. Données du Collége national des cardiologues des hôpitaux généraux (CNCHG).

The French epidemiological data on cardiac insufficiency in the hospital environment are scarce. A register collecting 1772 patients was produced by the services of the National College of General Hospital Cardiologists (C.N.C.H.G.) during two periods: autumn 1999 (November) and spring 2000 (June). It involved completing a form for each of the first 20 patients with cardiac failure hospitalized over a month. 1011 and 761 observations from 59 and 47 centres (that is 17 and 16 observations per centre) were collected during the autumn and spring periods respectively. In France, in the general hospital centres (CHG) cardiology services during the year 2000, the characteristics and the medical treatment of hospitalized patients with cardiac failure are very similar to those presented in 1998 by A. Cohen-Solal in the name of the working group "Cardiomyopathy and Cardiac Insuficiency of the French Society of Cardiology". The hospitalized patient with cardiac failure is very old, usually male, has an ischaemic cardiopathy in one in two cases, and is at stage II and III on the New York Heart Association (NYHA) scale in 83% of cases. There is practically always an electrocardiographic anomaly. Loop diuretics are prescribed nine times out of ten, digitalis one in three, anagiotensin converting enzyme inhibitors are underused being prescribed two out of three times, but an increase in the prescription of anti-aldosterone and betablockers is found. The majority of patients improve during their stay, 7.8% dying and this mortality is influenced by age, ejection fraction (FE), functional NYHA class, causal cardiopathy, and the existence of severe renal failure. The data collected by the cardiology services of the C.N.C.H.G. are representative of the profile of the population affected and are important to know in order to improve the management of these patients.