335 
through the ventricle, slowly indeed, but undisturbed i.e. without 
shocks. This produces co-ordinated contractions of the ventricular 
muscle *). 
The relationship between cardiac fibrillation and “gehdufte” extra- 
systoles may also appear from the fact that these forms are inter- 
changeable: ‘‘gehaufte’” extrasystoles may pass into ventricular 
fibrillation and conversely ventricular fibrillation may pass into 
“oehdufte’ extrasystoles. I will confine myself here by reproducing 
only an instance of the latter transition forms. 
Fig. 4 gives the suspension curves and the electrograms of a 
froe’s heart after bleeding. At 1 an electric stimulus reaches the 
ventricular base a little past the summit of the 7-deflection. This 
induces ventricular fibrillation, ending in an extra-systole. During 
this fibrillation the auricles continue their pulsations regularly and 
are delineated in the suspension-curve as slight elevations (marked 
by the letter A). The appearance of an extrasystole at the termina- 
tion of a fibrillation of the ventricle is a common phenomenon. 
Anyhow my curves frequently bore this out. 
After the preceding discussion this can be readily accounted for. 
I also often observed that fibrillation ended in a strong rise of the 
suspension-curve, which is illustrated in the curves of the first part 
of this communication and in my paper in Pfliigers’ Archiv *). This 
marked rise at the end of the fibrillation curve points to a contrac- 
tion of a rather large area of the heart muscles as the final phase 
of fibrillation. Upon this the excitation will readily rebound. The 
same explanation holds for the extrasystole with which fibrillation 
often concludes. After the extrasystole a prolonged pause appears 
and after this the normal rhythm ensues. I wish to draw attention 
to one more particular. Between the fibrillation and the extrasystole 
a small negative deflection occurs (indicated by an arrow). 
It is impossible to say for sure how this deflection has originated. 
It may be that after the fibrillation a retrograde excitation conduc- 
tion has given rise to an auricular contraction, which at that moment 
coincides in the suspension-curve with the extrasystole curve. Then 
) It stands to reason that in the case of this strongly retarded conduction of 
the excitation every ventricular contraction of the “gehäufte” extrasystoles is no 
of necessity a contraction of the whole ventricular muscle. No doubt partia] 
asystoles especially of the ventricular apex will occur during various “gehäufte” 
extrasystoles. So much anyhow appears from the figures reproduced by me. Of 
several “gehäufte” extrasystoles of these figures the negative T-deflections are 
smaller than may be anticipated from the considerably retarded conduction. It is 
most probably brought about by the partial apex-asystole. 
2) Pfliigers Archiv. Bd. 178. Seite 1. 
