[A new electrocardiographic technic: voluntary, sequential ambulatory recording]. / Etude d'une nouvelle technique électrocardiographique: l'enregistrement ambulatoire séquentiel volontaire.

Voluntary sequential ambulatory electrocardiographic is a new electrocardiographic diagnostic method. The recorder weighs 300 g and measures 156 X 95,5 X 19 mm. The electrodes, which are an integral part of the device, record the cardiac potentials from the hands and chest wall for a programmed interval of 40 or 20 seconds which can be repeated four or eight times. The recordings are in a solid memory and restituted on an electrocardiograph directly using a cable or by telephonic transmission. The bandpass ranges from 50 Hz to 0.05 Hz (analysis of the ST segment). Our experience after several hundreds of recordings shows: - that the recordings obtained are of good quality and perfectly interpretable (even the ST segment) when the patient cooperates satisfactorily; - that the "diagnostic return" is high because the patient only records when he experiences symptoms (the small size of the recorder enables the patient to wear it continuously for periods of several days); - that the need for the patient to play an active role always requires detailed instructions, a condition which sometimes limits the use of this technique (very old or very young patients). These results indicate that voluntary sequential ambulatory electrocardiography is a very promising technique for diagnosing some paroxysmal symptoms (palpitations, episodes of dizziness, chest pain). It does not supplant continuous electrocardiographic recording (Holter method), a more exacting and costly technique, but could significantly reduce its indications.

[Permanent intra-hisian atrioventricular block induced during right intraventricular exploration]. / Bloc auriculo-venticulaire intra-hisien définitif induit au cours d'une exploration endoventriculaire droite.

A 47 year old patient underwent endocavitary electrophysiological investigation for recurrent syncopal episodes occuring three years after an inaugural enterior myocardial infarction. Syncopal ventricular tachycardia was induced during the investigation when the bipolar catheter was in contact with the Bundle of His and several external electric shocks were required for its reduction. During cardioversion a complete intra-hisian atrio venticular block was observed and remained permanently although the values of the conduction intervals had previously been normal. This complication of defibrillation is thought to be the result of an induction phenomenon.

[Conduction disorders after aortic valve replacement. Apropos of 200 cases]. / Troubles conductifs après remplacement valvulaire aortique. A propos de 200 cas.

The following points become apparent after the study of 200 cases of aortic valve replacement:--Conduction defects are very common after this type of surgery, affecting one in three patients in this series;--Above all, the frequency of conduction defects of the left bundle branch (2/3 cases) must be underlined. They are much more common than complete atrioventricular block, bifascicular block or isolated right bundle branch block;--Diagnosed immediately after operation in almost all cases, regression is common (50%) especially of left anterior hemiblock;--The long term prognosis is good. There was no long or short term mortality due to this cause in this series;--Apart from traumatic lesions which are difficult to avoid when the aortic orifice is calcified, ischaemia of the conduction pathways due to insufficient myocardial protection probably plays a role in the aetiology of these conduction defects.

[Atypical forms of Ebstein's disease: value and limitations of ultrasonography and cardiac catheterization (author's transl)]. / Formes atypiques de la maladie d'Ebstein: apports et limites de l'échographie et du cathétérisme cardiaque.

Diagnostic ultrasonography signs of Ebstein's disease are delayed closing of the tricuspid valve in relation to the mitral valve, and the possibility of recording from the tricuspid valve when the transducer is outside of the left median clavicular line. These criteria were present in 8 out of a series of 10 cases and 6 of these patients had also had haemodynamic tests which showed auricularization of a portion of the right ventricle in all of them. Details are described for 3 of these patients to illustrate the different atypical clinical forms of Ebstein's disease, and the value and limitations of complementary investigations for establishing the diagnosis of this affection.

[Conduction abnormalities after single heart valve replacement (author's transl)]. / Troubles conductifs après remplacement monovalvulaire. A propos de 300 opérés.

A total of 300 patients were operated upon for heart valve disease by the same surgeon. The affected valve was the aortic in 200 cases and the mitral in the other 100 patients. The tricuspid valve, coronary arteries, and myocardium were not involved. This report attempts to define the frequency progression, prognosis, and significance of conduction abnormalities which appear during the course of this operation. In 35 cases, of which 16 were post-operative deaths, a histological examination of the conduction pathways was possible. The conclusions to be drawn from these observations are: Conduction abnormalities after single aortic or mitral valve replacement are frequent (1 out of 3 patients).

[Abnormalities of the aortic arch. Apropos of 30 surgical cases in children]. / Les anomalies de l'arc aortique. A propos de 30 cas opérés chez l'enfant

Few large surgical series have till now been devoted to aortic arch anomalies. Thirty cases operated upon in 10 years at the Hôpital Sainte-Justine are studied in the present work; they include: 8 cases of double-arch, 21 of aberrant subclavian arteries and 1 of aberrant brachio-cephalic trunk. In this apparently very complex embryological domain, a simplified classification, easy to remember even by the non-specialist, might be applied. There are no clinically significant differences between the various anatomical anomalies considered, the latter showing generally, soon after birth, by respiratory manifestations. The frequently severe spontaneous course requires an early diagnosis which relies on a simple procedure: the oesophagogram. A quick surgical treatment is then indicated, and the majority of our patients were operated upon in the early months of life. No post-operative death was observed and the long-term course might be considered as excellent in all the cases in which the malformation was alone and corrected early.