Archives of internal medicine . n was followed after a nearly normalinterval by a ventricular beat. On several occasions the administrationof atropin hypodermically resulted in the resumption, after about fifteenminutes, of normal auriculoventricular rhythm without essential changein the length of the a-c interval. In endeavoring to explain this phenom-enon we advanced the hypothesis that, owing to alternating Avaves ofvagus action, the strength of the impulses passing to auricle and ventriclewas at times so far diminished as to fail to produce a response in aventricle, the irritability of whi
Archives of internal medicine . n was followed after a nearly normalinterval by a ventricular beat. On several occasions the administrationof atropin hypodermically resulted in the resumption, after about fifteenminutes, of normal auriculoventricular rhythm without essential changein the length of the a-c interval. In endeavoring to explain this phenom-enon we advanced the hypothesis that, owing to alternating Avaves ofvagus action, the strength of the impulses passing to auricle and ventriclewas at times so far diminished as to fail to produce a response in aventricle, the irritability of which was, perhaps, reduced, or that, throughthe same influence, the irritability of the ventricle Avas further is not uninteresting that an analogous condition should have beenproduced experimentally in this case, in which, in addition to disease ofthe auriculoventricular bundle, myocardial disease was clearly present asindicated by the hypertrophy and dilatation and the diminished contrac-tility (alternating rhythm).. V- \fl ^ fy c 1 -(-» >> KJ -G sr > OJ ^ ? 1 M a> „ UJ _/. CO 0 I t N N / I - w CO c r C A c« X ^ 3 (N ^^ c :> o J <s t P »3 CC -^ t. ^. I ^ s ^ :3 s k C? i L-^ 342 THE ARCHIVES OF IXTEKXAL MEDICIXE Tracing 27, June 3, 1910: Coiaplete Aiiriruloventricular DissociationXiimerous tracings were taken on this date, but it was never n jssibleto obtain a record of other than a regular pulse, the occasional interpo-lated beats disappearing as soon as the patient la} down. Tracing 27shows auricular intervals varying from to , averaging 90 -f-, arate of about 66. The ventricular intervals vary fi-om to , aver-aging , a ventricular pulse of 38. On refei-ring to the key it may boseen that there is no constant relation between auricular and ventricularcontractions; there is apjoarently a complete dissociation. SUMMARY OF TRACTXGS AXD DISCUSSIOX OF THE CASE In summary the ti-acings from this ]iatipnt sliow: 1. Eegular auri
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