Demonstrates nervous control in the heart below the AV node, potentially in the ventricle itself, through carotid sinus pressure reproducing paroxysmal ventricular standstill.
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May indicate direct ventricular vagal effects; leaves open clinical relevance pending prospective confirmation.
A patient presenting syncope and convulsions was shown to have spontaneous attacks of ventricular standstill without preceding or subsequent partial heart block and with the auricles beating regularly throughout. Carotid sinus pressure reproduced one such attack. This is a demonstration of nervous control in the heart below the auriculoventricular node and perhaps in the ventricle itself. Cookson's term "paroxysmal ventricular standstill" is uniquely fitting. The presence of right bundle branch block raises the question of a lesion affecting both the left and right branches of the bundle of His.
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Ford K. Hick (1954) studied this question.
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