PARTIAL HEART BLOCK DUE TO DIGITALIS

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Abstract
One of the commonest causes of partial heart block is digitalis therapy. Frequently, in such cases, prolongation of the P-R interval occurred before digitalis therapy was begun. In those with partial heart block and dropped beats, and in those with latent heart block, the P-R interval averaged 0.21 sec. When there were no dropped beats, the P-R interval was on the average increased to 0.26 sec. Apart from the presence of latent heart block, the etiology of the underlying heart disease did not seem to be of importance, though congestive failure was present in the majority of patients. The presence of an infection seemed an important prerequisite to the development of partial block from digitalis therapy. When there were dropped beats, more than half of the cases had some infection at the time. Often, the infection was of trivial nature. In still others there was no infection, but serious damage to a heart was an additional factor making the conduction time more sensitive to digitalis than usual. Digitalis in large doses was rarely the cause of partial heart block nor were there any ill effects from its induction of heart block. There seems to be no reason why the chance finding of latent heart block should prevent adequate treatment with digitalis where this is indicated, though naturally the patient should be watched even more carefully than usual.

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