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NOTE ON THE USE OF EPINEPHRIN IN HEART BLOCK

H. M. KORNS, M.D.; C. D. CHRISTIE, M.D.
JAMA. 1922;79(19):1606-1607. doi:10.1001/jama.1922.02640190044016.
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Phear and Parkinson1 recently reported a case of complete heart block in which the sudden ventricular standstill responsible for syncopal attacks was entirely prevented by the subcutaneous injection of epinephrin. The heart block and the auricular and ventricular rates remained unchanged. Their review of the continental literature discloses only two cases, one of partial (2:1) block, the other of complete block, in which heart block was reduced or abated by epinephrin. In no case was partial heart block increased in degree, but in nearly all instances the auricular and ventricular rates were accelerated. Experimentally, however, it was shown by Kahn that complete auriculoventricular block may be produced in dogs by the intravenous injection of epinephrin. The paradoxical results reported by Routier, who describes a deblocking effect of epinephrin in dogs in which complete block had been produced by crushing the auriculoventricular bundle, failed of confirmation in the hands of

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