Combined spironolactone and converting-enzyme inhibitor therapy for refractory heart failure

Three cases are described of severe congestive heart failure which failed to respond to digitalis, high doses of loop diuretics, and converting-enzyme inhibitors. The addition of spironolactone produced a substantial diuresis associated with clinical and radiological improvement in each case. Although a reversible deterioration in renal function was observed, this drug combination represents a therapeutic option in end-stage heart failure.

Bipolar oesophageal electrocardiography and pacing in a coronary care unit

This paper describes our experience with bipolar oesophageal electrocardiography in a coronary care unit. Twenty-two patients with tachycardia were studied to clarify the nature of their tachycardia. The treatment of supraventricular tachycardia by rapid atrial pacing via the same electrode was assessed in eight patients. The equipment required and diagnostic and therapeutic applications of oesophageal electrocardiography in this setting are discussed.