Auricular fibrillation and its relationship to clinical irregularity of the heart / by Thomas Lewis.
- Thomas Lewis
- Date:
- [1910?]
Licence: In copyright
Credit: Auricular fibrillation and its relationship to clinical irregularity of the heart / by Thomas Lewis. Source: Wellcome Collection.
66/80 page 368
![College Hospital. My thanks are os])ecially due to Dr. James Mackenzie and to Dr. .lolin Hose Bradford. CiriEF CONCLUSIONS. 1. Amongst the many forms of persistent irregularity of the human heart, none is more common tlian that whicli may be termed complete irregularity of the heart. It is accom])anied by an absence of all sign of normal auricular action ; and it is due to fibrillation of the auricle. 2. Auricular fibrillation as a pathological and clinical entity e.xhibits certain definite signs. Amongst tlie distinguishing features the following are the most important. a) Absolute irregularity of the ventricle. h) The ventricular form of venous pulse. r) A characteristic electrocardiogram, in which the ventricular curve is of the usual type, but in which the normal auricular representative is replaced by a series of rapid oscillations, which are su})erimposed upon the rest of the curve and deform it. The oscillations are generated in the auricle, and are the result of the fibrillation. 3. Digitalis retards the ventricular rate in clinical auricular fibrillation by enhancing a previously existing auriculo-ventricular heart-block. The rapid and irregular im])ulscs showered upon the ventricle from the fibrillating auricle are hindered in their passage from one chamber to the other by the action of drugs of this class. The influence of digitalis is exerted, directly or through the vagus, u])on the junctional tissues. 4. Auricular fibrillation in man maybe accom]>anied by heart-block of all grades, and the heart-block may or may not result from digitalis administration. When the heart-block is complete the ventricular action is slow and regular. 5. A rhythm arising in the neighbourhood of the node of Tawara is a real clinical ])hcnomenon. It is distinct from the mechanism which produces complete irregularity, and it is a rare affection,](https://iiif.wellcomecollection.org/image/b29000610_0066.jp2/full/800%2C/0/default.jpg)
