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The special problems of pacemaker-therapy in infants and children are reported and compared with those of adults. The possibilities of application of pacemakers and the indications for temporary or permanent use are discussed. Special attention is paid to the disadvantages of presently available pacemakers for children due to electro-physiologic and hemodynamic facts. Complications of pacemaker-therapy and wishes in regard to technical improvements of pacemakers are discussed too. The possibilities of checking pacemaker patients are also mentioned. The therapeutic value of pacemaker for pediatric patients is analysed, using the results of the literature and an own experience with an infant, which is discussed in detail.

The purpose of the study was to evaluate the effects of nitroglycerin on the mechanical and metabolic performance of the mammalian heart without interference from peripheral vascular and neurohumoral influences. Isolated rat hearts were perfused with a buffer containing 1 mug of alcoholic nitroglycerin/ml or an equivalent amount of alcohol. Mechanical performance was analyzed during external and isovolumic work; all hearts were subjected to mild hypoxia. Heart rate was kept constant by pacing. At constant atrial filling pressures end diastolic pressures and calculated wall stiffness were not significantly different for controls and nitroglycerin. Afterload, as quantitated by mean aortic pressure, was the same for both groups. Peak-systolic left ventricular pressure and dp/dt max during ejection and isovolumic work were significantly reduced by hypoxia (p less than 0.001), but not changed by nitroglycerin. Cardiac output, mean systolic left ventricular pressure, work, oxygen consumption, and calculated efficiency were decreased by hypoxia (p less than 0.001); lactate production was enhanced by the hypoxic state (p less than 0.001). Nitroglycerin had no influence on these parameters in either state. It is concluded that at constant rate, preload and afterload nitroglycerin has no effect on the mechanical performance and energy formation by aerobic and anaerobic means in the fully oxygenated and mild hypoxic state.

In 1971 a population-based Ischaemic Heart Disease (IHD) Register was established in the Innsbruck area as part of the WHO international collaborative study. Demographic and geographic data covering the area, as well as the locally-applied methods are described. One hundred and seventy four cases (133 males and 41 females) of acute myocardial infarction (AMI) were registered in the age group 20-64 years. This corresponds to an annual incidence rate of 1.9(0/00) in men and 0.6(0/00) in women. These results confirm indications from the national mortality statistics that Innsbruck belongs to the group of areas in Europe with a relatively low incidence of AMI. The epidemiology of AMI in Europe is discussed. The frequency distribution of AMI according to month of the year, day of the week and hour of the day is reported for this area.

Bei der medikamentosen Behandlung von Rhythmusstorungen in der akuten Phase des Myokardinfarktes sind vor allem drei Gesichtspunkte zu berucksichtigen, die Anwendung und Dosierung der in Frage kommenden Substanz beeinflussen.

Liver metastases of a malignant tumour of the carotid body were investigated by biochemical, immunological and morphological methods. Osmiophilic secretory granules could be seen in electron micrographs. Noradrenaline, dopamine β-hydroxylase and chromomembrin B could be demonstrated in the tumour tissue. These results indicate that this tumour of the carotid body contained secretory granules which resembled the catecholamine-storing vesicles (chromaffin granules) of adrenal medulla.