[Unilateral auricular paralysis and dissociated ectopic auricular rhythm. Apropos of 4 cases]

The authors report four cases of right atrial palsy associated with tachycardia and/or slow atrial rhythm from the left auricle in elderly subjects with a past history of cardiac failure with atrial fibrillation for about ten years; they were digitalised and had cardiac failure, and in addition there was one perisinus block and one paroxysmal or persistant complete block situated above the bundle of His and probably above the AV node itself, secondary to the condition of atrial palsy. This probably represents an intermediate stage between chronic atrial fibrillation and atrial palsy in an elderly subject. These cases require careful intracavitary investigation, and often treatment by pacemaker and digitalis.