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Article
July 1922

AN ELECTROCARDIOGRAPHIC STUDY OF FIFTY PATIENTS DURING OPERATION

Author Affiliations

PEKING, CHINA; BOSTON

From the medical and surgical clinics of the Peter Bent Brigham Hospital.

Arch Intern Med (Chic). 1922;30(1):57-72. doi:10.1001/archinte.1922.00110070060004
Abstract

For a thorough understanding of the action of the heart, it is important that it be studied under various conditions of stress. This investigation was undertaken to determine whether there are any abnormalities in the mechanism of the heart beat, demonstrable by electrocardiography, during the period of anesthetization and surgical operation.

Heard and Strauss1 reported a case of atrioventricular rhythm detected electrocardiographically in a patient still under ether following an operation. They state, "no other cases of nodal rhythm have been observed by us in a series of twenty-one cases in which electrocardiographic records have been taken during anesthesia." Levine2 reported cases of acute cardiac upsets occurring in association with surgical operations. In two of his cases electrocardiographic tracings were made during attacks of paroxysmal auricular tachycardia while the patients were still under ether. These two reports were the only references to the subject found in the literature.

MATERIAL AND 

References
1.
Heard, J. D., and Strauss, A. E.:  An Electrocardiographic Study of Two Cases of Nodal Rhythm Exhibiting R-P Intervals ,  Am. J. M. Sc. 75:238, 1918.Crossref
2.
Levine, S. A.:  Acute Cardiac Upsets Occurring During or Following Surgical Operations ,  J. A. M. A. 75:796 ( (Sept. 18) ) 1920.
3.
Cohn, A. E.:  A New Electrode for Use in Clinical Electrocardiography ,  Arch. Int. Med. 26:105 ( (July) ) 1920.Crossref
4.
Krumbhaar, E. B.:  Electrocardiographic Observations in Toxic Goiter ,  Am. J. M. Sc. 155:175, 1918.Crossref
5.
Wilson. F. N.:  Three Cases Showing Changes in the Location of the Cardiac Pacemaker Associated with Respiration ,  Arch. Int. Med. 16:86 ( (July) ) 1915.Crossref
6.
Wilson, F. N.:  The Production of Atrioventricular Rhythm in Man After the Administration of Atropin ,  Arch. Int. Med. 16:994 ( (Dec.) ) 1915.
7.
Levine, S. A.:  The Action of Strophanthin on the Living Cat's Heart ,  J. Exper. M. 29:493, 1919.Crossref
8.
Barker, L. F., and Richardson, H. B.:  An Unusual Combination of Cardiac Arrhythmia of Atrial Origin Occurring in a Patient with Focal Infection and Thyroid Adenomata ,  Arch. Int. Med. 23:158 ( (Feb.) ) 1919.Crossref
9.
Carter, E. P., and Wedd, A. M.:  Observations on the Occurrence of inverted and Diphasic P Waves in Lead III of the Human Electrocardiogram ,  Arch. Int. Med. 23:16 ( (Jan.) ) 1919.Crossref
10.
Lewis, T.:  The Mechanism and Graphic Representation of the Heart Beat , New York, Paul B. Hoeber, 1920, p. 189.
11.
White, P. D.:  Clinical Observations on Unusual Mechanisms of the Auricular Pacemaker ,  Arch. Int. Med. 25:423 ( (March) ) 1920.Crossref
12.
White, P. D.:  Auricular Standstill, an Unusual Effect of Digitalis on the Heart with Special Reference to the Electrocardiograph ,  Boston M. & S. J. 175:233, 1916.
13.
Goddard, C. H.:  Changes in the P Wave of the Human Electrocardiogram ,  Arch. Int. Med. 16:133 ( (July) ) 1915.
14.
White, P. D.:  Ventricular Escape with Observations on Cases Showing Ventricular Rate Greater than that of the Auricles  Arch. Int. Med. 18:244 ( (Aug.) ) 1916.
15.
Cohn, A. E.:  The Effect of Morphin on the Mechanism of the Dog's Heart After Removal of One Vague Nerve ,  J. Exper. M. 18:715, 1913.
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17.
A table giving detail of cases appears in authors' reprints.
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