Digoxin did not reduce overall mortality, but it reduced the rate of hospitalization both overall and for worsening heart failure. These findings define more precisely the role of digoxin in the management of chronic heart failure.

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ESTING 12-LEAD ELECTROCARdiogram (ECG) abnormalities are independently associated with incident coronary heart disease (CHD) and cardiovascular disease (CVD) events. 1-14 Many of the prior studies included only men or compared men and women, but the women were not selected for age or the presence or absence of underlying heart disease. 1-13 Data are sparse regarding the prognostic significance of baseline ECG abnormalities in postmenopausal women without clinically manifest heart disease. 14 Furthermore, there is no information on the prognostic significance of incident ECG abnormalities. The Women's Health Initiative (WHI) clinical trials of hormone therapy examined whether in healthy postmenopausal women a combination of estrogen and progestin would reduce CHD and CVD events. 15 The study showed that there was a significant increase in CHD rates among women taking hormone therapy compared with the placebo group. 16 A subsequently published article on the risk of CHD found that clinical characteristics or biomarkers did not significantly modify the treatment-related risk of CHD end points. 17

SUMMARYElectrophysiological evidence suggestive of dual atrioventricular (A-V) nodal pathways is presented in two patients with normal P-R interval and reentrant paroxysmal supraventricular tachycardia (PSVT). His bundle recordings and atrial stimulation were used to obtain this electrophysiological evidence. Recently reported studies in man suggest that A-V nodal reentrance is a common mechanism of paroxysmal supraventricular tachycardia (PSVT) .6-8 A-V nodal reentrance implies either the presence of dual A-V nodal pathways or reentry by "reflection" in an area of depressed conduction.9' 10 The purpose of this report is to describe two patients with history of PSVT and normal P-R 549 by guest on May 7, 2018 http://circ.ahajournals.org/ Downloaded from