A total cases of 1, 397 general anesthesia were recorded EKG at random during the past 6 years. The ages of patient were between 20 and 80-years-old, of which male comprised 482 cases and female 915 cases. EKG monitering by oscilloscope was started before in-duction of anesthesia and was continued until the end of anesthesia and recordings were kept before anesthesia, during anesthesia and at time abnormal state occured if any.
The observation were done with 4 anesthesia method group of GOF, GOP, NLA-original and NLA-modify, and each of these were devided into a group using relaxant and a group not using relaxant, and the former group were devided further into DNT, PB and SCC. Incidence rate of arrhythmia during anesthesia was highest on the GOF+SCC group with 37 cases in 137 cases (27.0%) and significant difference in arrhythmia was recognized in GOF+SCC group over the other three groups. There were no special evidence that ar-rhythmia incidence rate of GOP and NLA groups is less than that of GOF group

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Eight patients, age of 47-to 76-years-old, with Stokes-Adams attacks underlying brady-arrhythmias were studied with EEG before and after implantation of intracardiac pace-maker. Postoperative studies showed that in two of the eight cases the frequency (Hz) of basic activity had been faster, in three of the eight the basic a-waves had significantly increased, in one case with low voltage fast pattern before pacing α-rhythm had appeared and in one case the paroxysmal θ-burst had disappeared, and in one case with diffuse a II no remarkable changes had been noted except the α-continuity.
The changes in EEG paralleled the clinical improvement following the pacemaker implantation

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It is well documented that about 90% of patients with mucocutaneous lymphnode syndrome (MCLS) show clinical signs and symptoms indicating cardiovascular lesions. Especially the incidence of electrocardiographic abnormalities is high. It is, therefore, very important to study serial recordings of EKG in the course of the disease.
This report describes electrocardiographic findings in the acute stage of the disease in 24 children. The criteria of the abnormal changes of the EKG were as follows: (1) PQ prolongation more than 0.16 sec., (2) QTc more than 0.42, (3) ST changes more than 0.2mV, (4) changes of R wave more than 0.5mV and (5) changes of T wave more than 0.2mV.
One or more abnormalities were found in 23 of 24 patients (96%). Frequently found abnormalities were QTc increase (88%), PQ prolongation(54%), increased voltage of R wave (38%) and decreased voltage of R wave (21%). QTc increase was observed over the wide range of the course of the illness. PQ prolongation, low voltage of R wave and flattened T wave were found from the beginning of the disease to the second week. There was no correlation between EKG changes and Asai's score. Although the EKG abnormalities might not be found in a single recording, they were obtained by serial recording during the illness.
The above EKG changes were the same as commonly found in myocarditis, never con-sistent with those observed in coronary artery disease. This is compatible with the fact that there was no correlation between the EKG changes and Asai's score, which was closely related with the presence of coronary artery lesions in MCLS

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After an open heart surgery, general condition is so unstable, that the arrhythmias on these conditions effect the prognosis more serious than preoperative or late operative ones. The present study was undertaken to investigate the postoperative transient arrhythmia, whick should be treated for.
M. V. R. were carried out in 5 patients and A. V. R in 6 patients. Under an extra corporeal circulation with moderate hypothermia methods, cardiac muscle protection was carried out by the coronary perfusion with G. I. K, and local cooling of the cardiac surface with crushed ice. Cardiac arrest was got by the Young's fluids. We have made all cases hyperalimentation therapies or G. I. K. therapies for several days or one week before the operation.
All cases were confined in C. C. U. after operations. In all cases, arrhythmia had appeared during postoperative course. Postoperative ventilations were controlled by volume limited ventilators for 24 hours just after operations, then we began weanings with I. M. V. and P. E. E. P. All cases could get weanings from ventilators in a few days or a week.
Among postoperative arrhythmias that exert great influence on circulatory dynamics, supraventricular premature beats and ventricular premature beats were investigated. S.V.P.B. were seen in 8 cases and V. P. B. were in 3. In two cases V. P. B. changed to ventricular fibrillation, for which cause we suspected a hypopotassemia.
Arrhythmia could be seen often within the first 6 to 8 hours of a surgery. During this periods there is tendency of hypopotassemia and high density of serum digoxin, we observed. We made in all cases right ventricular pacings for the purpose of preventing postoperative arrhythmias. One of these, we added an atrial pacing. The atrial pacing could make easy to the control of postoperative S. V. P. B.

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The prognosis of cardiac pacemaker implantation, which were done in Yokohama National Hospital from June 1, 1971 to April 31, 1980, was reported. Total 30 patients, 15 were male and 15 were female, had received 40 implantation procedures. Patients mean age is 61.8 years with a range of 9 to 81 years.
Dysrhythmias required pacemaker implantation were as follow: complete A-V block (10 cases), second degree A-V block (6 cases), sick sinus syndrome (7 cases), bradycardia caused by atrial fibrillation (7 cases).
Syncope attack (Adams-Stokes Syndrome) occured in all patients before pacemaker implantation.
Postoperative deaths was 6 cases (20%). The cause of death was rectal cancer, mammary cancer, senescence and sudden death.
The complication of pacemaker implantation was 5 cases, an acceleration of pacing (runaway pacemaker), one infection, two dislocation of the endocardial lead, one discon-nection of myocardial lead.
All survival cases (24 cases) lead a happy life

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In 8 patients treated for sick sinus syndrome with pacemaker implantation, sinus node recovery time (SRT), His-bundle electrogram, basic rhythm after pacemaker implantation were studied.
Only 3 patients have abnormal SRT. After the follow-up periods of 12 to 77 months, 2 cases were still symptomatic, and 4 cases showed faster basic rhythms.
For a patient with normal SRT without syncopal attack, it is difficult to decide an indication for permanent pacing. Clinical and electrocardiographic evaluation remains the best mean of establishing an indication for pacemaker implantation

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From July, 1972, to September, 1979, 40 patients were admitted to the Nagasaki Chuo National Hospital, and were implanted pace-makers. Our series comprises 21 men and 19 women ranging in age from 28 to 84 years, with average age of 64.8 years. 33 of 40 patients survived with no major complication.
From our small series, we might suggest that life-saving and life-lengthening effects as well as the improvement in the quality of life provided by treatment remain undisputable

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Two hundred and fifty-four patients under 15-years-old underwent cardiac operation at Nagasaki Chuo National Hospital, during period from April, 1972 through March, 1979, 148 patients (58%) aged 4 days to 15 years underwent heart surgery without homologous blood transfusion before, during and after operations.
One hundred and seventeen infants and children received open heart surgery under profound hypothermia by surface cooling, and 88 patients (75%) between 1 year and 15 year of age underwent open heart surgery without homologous blood transfusion, using intra-operative autologous blood transfusion and 3% Dextran Lactate-Ringer solution.
Fifty-five (71%) of 77 patients without open heart operations underwent heart surgery without homologous blood transfusion, including a case of a four-days-old infant with tri-cuspid atresia.
Profound hypothermia by surface cooling is a useful method for open heart surgery without homologous blood transfusion in children with simple congenital heart diseases

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This paper is an analysis of 1, 041 cases of cardiovascular diseases operated on, between January 1978 and December 1979.
Five hundred and twenty-six of these 1, 041 cases were congenital heart disease(CHD). and 515 were acquired heart disease(AHD).
1) The review of 526 cases of CHD.
The results of the operations for ASD, VSD, PS, and PDA were excellent except for the rare cases. PDA was treated by the method of ligation of ductus in all cases in 1979, and axillary approaches were used in 19 cases.
Otherwise, the results of the operations for 74 cases of complex heart diseases including 39 cases of TF and 18 cases of ECD were very poor; the mortality rates were as follows; 17% of TF, 22% of ECD, and 48% of other complex heart diseases. Thus we must continue efforts to reduce the deleterious efforts hereafter.
2) The review of 515 cases of AHD.
Among the 98 cases of MS, 70 cases were treated by open mitral commissurotomy, and 18 cases were by mitral valvar replacement (MVR). Of the 55 cases of other mitral valvar diseases, 54 cases were treated by open operation, and 51 cases were MVR.
Among the 26 cases of aortic valvar diseases, 23 cases were AVR. All of the 50 cases of combined valvar diseases were treated in open operation. The mortality rate of the 131 cases of valvar replacement was 11%.
The results of the operations for 72 cases of ischemic heart diseases were satisfactory in 66 cases (92%).
The managements with implanted pacemakers were reliable in 166 cases except for one

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A twenty-two-years-old male presented a slow junctional rhythm without “P” wave activity and was subsequently found to have atrial paralysis.
The EKG revealed a slow junctional rhythm at 48/min without “P” wave activity.
The vectorcardiogram showed normal QRS loops but no identifiable P loops.
Intracavitary EKGs recorded simultaneously with the scalar EKG showed no evidence of P wave activity. And absence of “A” wave in right atrial pressure curve.
The His's bundle electrogram revealed no “A” spike, but “H” and “V” potentials were clearly seen.
The H-V time was 70 msec.
Attempts at pacing the right atrium at various sites with stimuli up to 20 mA were unsuccessful.
This patient has no complications

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A twenty-nine-years-old woman without known heart disease became dyspneic three days after the full term of normal delivery. Six days after delivery, her condition deterio-rated to the extent that she became orthopneic and she was brought to Okayama National Hospital in emergency.
The echocardiography revealed a wide left ventricular chamber with a hypokinetic inter-ventricular septum and left ventricular posterior wall, and she was diagnosed as post-partum cardiomyopathy. Digitalis and diuretics were started without relief of dyspnea. Prazosin and nitroglycerin were added as a vasodilator, but the effect of the vasodilating drugs was temporary and she remained dyspneic. Then, the ultrafiltration method was adopted to dehydrate the patient, but the effect was so minimal that the patient died twenty-three days after the delivery.
The autopsy was performed. Both ventricular chambers were remarkably dilated and mural thrombus was found at the left ventricular apex. Histologically, the myocardium showed varying degrees of atrophy and degeneration of muscle fibers. In the pulmonary arteries, massive thrombus was found, which had made this disease refractory to the thera-py, and it was thought to have come from the pelvic or deep vein thrombus.
It was further discovered that the mother of this patient died of a heart disease forty days after the delivery of her second child, i. e. this patient. There are, also, several reports on record of the familial ocurrence of postpartum heart failure. The genetic factor, therefore, may be suspected in the case of this patient

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Cardiac failure due to aortic insufficiency, caused by bacterial endocarditis, progress rapidly and sometimes develop into lethal cardiac failure. We could not save one case because of missing an opportunity for operation.
A 46-years-old man complained of dyspnea and remittent fever. Although blood cultures were negative, clinical signs and laboratory data suggested bacterial endocarditis. Two-dimentional echocardiography revealed masssive vegetation on the right coronary cusp of the aortic valve. On the day before operation, heart failure progressed abruptly. Emergency operation was attempted but proved fruitless.
The purpose of this report is to describe necessity of early operation for aortic insufficiency in bacterial endocarditis

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