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By John Rawles BSc, MB, BS, FRCP, FRCP (Edin) (auth.)

Atrial traumatic inflammation is a typical and demanding arrythmia which impacts nearly5% of peopple over 70. This synthesis of present wisdom that is established onmuch unique paintings by means of the writer brings togeher for the 1st time the various components of strengthen lately and may aid to make specialists from the hugely specialized fields inside cardiology conscious of the advancements withinothers.

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Several authors who have studied the distribution of R-R intervals in atrial fibrillation have noted that the histograms are not always unimodal but may show two or more peaks. Thus, Soderstrom (1950) remarks on the tendency for R-R intervals to congregate around durations of 350,700,1000 and 1400 milliseconds. Goldstein and Barnett (1967) reported that modes most commonly occurred at about 450 and 650 milliseconds but were observed anywhere from 350 to 1350 milliseconds. Horan and Kistler (1961) noted a tendency for histograms to have a single peak at high ventricular rates, a double peak at intermediate rates, and a low single peak at low rates.

Akiyama et al. (1989) have reported two cases of atrial fibrillation exhibiting "Ashman phenomenon of the T wave". In the absence of aberrancy of QRS complexes there was T wave inversion after short preceding intervals, accentuated by a long pre- preceding interval. References Aberg H (1969) Atrial fibrillation. II. A study of fibrillatory wave size on the regular scalar electrocardiogram. Acta Med Scand 185:381-5 Aberg H, Strom G, Werner I (1972) Heart rate during exercise in patients with atrial fibrillation.

Such monophasic action potentials occur with a frequency of 2-700 per minute and have a widely variable duration inversely related to their frequency, though with high frequencies demarcation of consecutive action potentials is difficult or impossible. The characteristics of the fibrillatory waves recorded in this way are no different in patients with paroxysmal or chronic atrial fibrillation, or in those with underlying rheumatic or coronary heart disease (Cotoi et al. 1979). Patients with longer and less frequent action potentials are more likely to convert to, and remain in, sinus rhythm than those with more rapid fibrillation associated with shorter action potentials (Gavrilescu et al.

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