[Is isolated atrial fibrillation genetically determined? Apropos of a familial history]. / La fibrillation auriculaire isolée est-elle une maladie génétique? A propos d'une histoire familiale.

The authors report five cases of apparently lone atrial fibrillation in five members of the same family from three generations. The atrial fibrillation occurred at an early age and rapidly became permanent in all cases. With time, in the absence of complications, structural cardiac abnormalities were documented by echocardiography (biatrial dilatation and mitral and tricuspid regurgitation). These observations raise the question of genetic predisposition to lone atrial fibrillation at least in this particular clinical context.

[Excision of an intracardiac metastasis under chemotherapy]. / Exérèse d'une métastase intra-cardiaque sous chimiothérapie.

An intracardiac malignant lesion was found in a 28-year old male patient following orchidectomy for an advanced germinal tumour of the testicle. Although the patient is under chemotherapy, the neoplastic thrombus will be removed by surgery. Heart metastases are uncommon. When they do occur, they are usually secondary to locoregional extension and limited to the pericardium or myocardium. Endocardial or intracavitary lesions are rare, but can, in certain cases, be removed by surgery.

[Infarction of the right ventricle. 1. Hemodynamic diagnosis; pathologic correlations]. / L'infarctus du ventricule droit. 1. Diagnostic hémodynamique - corrélations anatomiques

70 patients with acute myocardial infarction were submitted to a full haemodynamic assessment at the onset of the condition. In 28 of them there was a disproportionate rise in the right ventricular end-diastolic pressure which could not be explained on the basis of a primary rise in left ventricular filling pressures; these were divisable into two subgroups: -- 19 infarcts without septal rupture, almost all with an inferiorly or posteriorly placed lesion (17); in these cases, an analysis of the curves shows, among other features, a syndrome of adiastole whose three forms (minor, moderate or severe) correlate well with the clinical features. Six cases died, and in four of those it was possible to study the correlation with the post-mortem findings: there were major lesions of the free wall of the right ventricle in 3 cases, but constrictive pericardial changes, the main differential diagnosis of right ventricular infarction, in the fourth. -- 9 cases of necrosis of the septum with rupture, of which only 3 had a syndrome of adiastole; three of these necroses were posterior, and post-mortem examination in two of them confirmed that there were indeed major lesions in the posterior wall of the right ventricle. It therefore seems that the diagnosis of infarction of the right ventricle is a haemodynamic one, and rests especially on the discovery of a syndrome of adiastole. Findings such as these are confined almost exclusively to posteriorly placed infarctions.