Fatty Infiltration (Lipomatosis) of the Auriculoventricular Bundle of His, With Sudden Unexpected Death

Numerous studies have established a definite relationship between the symptoms usually referred to as Adams-Stokes disease and changes in the auriculoventricular bundle of the heart, the bundle of His. The absence of sufficient information in many of the reports in a recent summary by Bachman1led him to base this definite relationship on the evidence in only twenty-four of the eighty-six cases reviewed; in the remainder the details were inadequate for comparison. In these twenty-four, to which I have added a few2not in the number considered by Bachman, the alterations found in the His bundle were as follows : From a study of such a table as this it is evident that well-marked examples of the Adams-Stokes syndrome have for their explanation a lesion of the auriculoventricular bundle. A number of careful studies have shown that a complete transverse lesion of the main stem of this conducting