An abnormal relationship of the electrical to the mechanical response in the ventricles

The record described in this paper was made on a man aged 64, who was suffering from complete heart block (Plate 1, fig. 1). The characteristic features peculiar to it were observed on one occasion only, although numerous other records were made on the same subject. It was impossible to continue the observations as the patient developed acute tonsillitis and died of œdema of the glottis. The observation in question is shown in Plate 1, fig. 2, in which the lower record is an electrocardiogram taken with a sensitive string at about one-eighth of the usual magnification, and the upper record is a combined carotid and radial sphygmogram taken by a method previously described by Bramwell and Hill (5), employing a hot-wire sphygmograph(1)(2). In this particular instance the carotid receiver was placed low down in the neck, and consequently not only arterial but also certain additional waves from the internal jugular vein were recorded.