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Observations with Special Reference to the Critical Heart Rate

MARTIN A. SHEARN, M.D.; DAVID A. RYTAND, M.D.

AMA Arch Intern Med. 1953;91(4):448-463.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

INTERMITTENT bundle-branch block, a not uncommon electrocardiographic finding, is encountered mainly in elderly people or patients with organic heart disease.¹ Rarely it is found in a person with an otherwise normal heart,² though its mere presence is taken by some³ to be evidence of heart disease. The rarity of this condition in the absence of heart disease was borne out by the study of Comeau, Hamilton, and White³ wherein they found only 6 patients of a total of 77 with intermittent bundle-branch block in whom myocardial disease could not be implicated. In reviewing the pertinent medical literature since Comeau's analysis, Sandberg and co-workers⁴ reached a similar conclusion; they found that only 6 patients of a total of 82 with intermittent bundle-branch block had no apparent heart disease.

Because of the underlying disease in patients with this condition, the conducting system becomes so modified that a point is reached where even . . . [Full Text PDF of this Article]

Author Affiliations
SAN FRANCISCO

From the Department of Medicine, Stanford University School of Medicine.