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Normal and accessory A-V conduction were analyzed by His bundle recordings in a 49-year-old patient with WPW-syndrome type A. An open foramen ovale permitted registration of left atrial potentials as well as left atrial pacing. The effects of the pacemaker site (left or right atrial pacing) on the electrocardiographic variability of pre-excitation were studied. The effective refractory period of the accessory A-V conduction was shown to be dependent on the site of pacing. Recordings of right and left atrial potentials during runs of supraventricular tachycardia demonstrated that V-A conduction occurred via the accessory pathway.

Intra-aortic balloon counterpulsation (IABP) was used in 20 patients with acute myocardial infarction and cardiogenic shock, after four hours of drug treatment. In all instances the abnormal haemodynamic state had been demonstrated. Four patients were successfully treated and finally discharged home. In two with post-infarction ventricular septal defect and cardiogenic shock, IABP also successfully reversed the shock state, while in seven the shock state was reversed but they died 2-8 days after IABP had been stopped. IABP failed in seven patients who died during its application. In those in whom IABP failed there had been no significant fall in pulmonary-artery pressure and no significant increase in stroke volume. The post-mortem examinations demonstrated that cardiogenic shock was irreversible where more than 50% of the left ventricular myocardium had been infarcted.

Bei Patienten mit kombinierten Mitralfehlern besteht die Aufgabe, den Insuffizienzanteil von dem Anteil der Stenose abzugrenzen. Die Bedeutung des Problems geht allein daraus hervor, das neben der Auswertung klinischer Daten spezielle Untersuchungsmethoden entwickelt wurden, die meist auf der Analyse des direkt oder indirekt registrierten Druckablaufes im linken Vorhof beruhen. Der direkte Nachweis des Insuffizienzanteiles gelingt durch im linken Vorhof direkt aufgenommene Indikatorverdunnungskurven nach Injektion des Indikators in den linken Ventrikel. Seit 1956 ist verschiedentlich uber dieses Vorgehen im Modellversuch, im Tierexperiment und bei Patienten berichtet worden (3, 4, 5, 6, 7, 8). Es gestattet neben dem direkten Nachweis einer mitralen Regurgitation einen Vergleich mit simultan aufgenommenen Druckkurven im linken Vorhof und im linken Ventrikel.