Arhythmia [sic] of the heart : a physiological and clinical study / by K.F. Wenchkebach ; tr. by Thos. Snowball.

  • Karel Frederik Wenckebach
Date:
1904
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Licence: In copyright

Credit: Arhythmia [sic] of the heart : a physiological and clinical study / by K.F. Wenchkebach ; tr. by Thos. Snowball. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    strength; and the stimulus, coming so soon after the preceding systole, is not yet conducted so quickly, and therefore does not arrive at the auricle until 7 time-units after A2, or at the ventricle until 8 units after V2. The next spontaneous stimulus after it is conducted again nearer the normal. As the result shows, the rhythm in the sinus was 10, 4, 10, 10, &c., in the auricle 10, 7, 8,. 9, 10, 10, &c., but in the ventricle 10, 8, 8, 8*5, 9-5, 10, &c., in which therefore the disturbance was least accentuated. Other examples of the same phenomenon are given in Fig. II. B and C. In B we see that S3. which came very quickly after S2, A. B. 10 4 | 10 10 10 to IO 2 5 13 .5 IO 10 IO 1 S S 1 1. Z j 5. G. 7. Z 2 3 4 5 6 7. 10 \ 7\ 8 .9 \ 10 \ 10 \ A A' 70 8 5 |j-5: 12 \ 10 \ IO /. 3. 4, 4 6 7\ / 2 3. 4 5 6 \ 7. V' 10 \ 8 \ 8 \ 8 5. 0 5. IO - > 10 9 -5 \ 15 5 77 \ 1° \ 1 Z 3 4 5 6 7 1 & 3 4 5 6 c. t IO Z 14 A 10 10 JO /. 2 3 -< 0 G 7 12 V1 • \l 10 \ 12:5 12 11 5 \ IO \ yl : 1 2 3 4 3 6 V Fig. II.—After Engelmann. is conducted to A very slowly; but as the conductivity has had time to recover itself again, V3 follows soon after A3. On the other hand, Si can be quickly conducted to A ; but as it now finds the ventricle still in the refractory phase, the latter does not contract at all. In C the extra-stimulus occurs still earlier; the sinus con- tracts, but as the stimulus is not yet conducted further, neither the auricle nor the ventricle contracts. After the long pause which thus ensues, however, the stimulus is conducted so quickly through the heart-muscle that A3 and V3 appear a little earlier than they would have done had the rhythm remained constant. In this way the disturbance is here again more equalised.