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October 1915


Author Affiliations


From the Wards and Outpatient Department of the Massachusetts General Hospital.

Arch Intern Med (Chic). 1915;XVI(4):517-535. doi:10.1001/archinte.1915.00080040013002

A cardiac rhythm arising in the atrioventricular junctional tissues in the human is a rare and usually very transient affection, so uncommon in fact that it has never been the object of careful investigation. Premature beats and paroxysms of tachycardia having their origin in the junctional tissues have been reported frequently. Belski1 in 1909 wrote of six cases of acute infectious disease in which polygrams seemed to indicate that the bradycardia was not infrequently due to an atrioventricular rhythm. In one case the subcutaneous injection of atropin sulphate, gram 0.001, produced in twenty minutes an acceleration of the pulse from 42 to 137, while the rhythm apparently changed from one arising in the atrioventricular junctional tissues to one of the normal sino-auricular type. Five hours after the atropin had been given the pulse had dropped to 55 and the rhythm was still normal. The next day at

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