Data from ambulatory electrocardiographic recording in 35 highly trained endurance athletes and in 35 non-athletic controls of similar ages are given. The minimal, mean hourly, and maximal heart rates were significantly lower in the athletes. Thirteen athletes (37 . 1%) but only two controls (5 . 7%) had sinus pauses exceeding 2 . 0 seconds. First degree atrioventricular block was observed in 13 athletes (37 . 1%) and five controls (14 . 3%), second degree Wenckebach type block in eight athletes (22 . 9%) and two controls (5 . 7%), and second degree block with Mobitz II-like pattern in three athletes (8 . 6%) and no control. All athletes with Mobitz II-type pattern also had first degree and Wenckebach-type second degree atrioventricular block. The behavior of sinus rate on development of atrioventricular block varied, not only interindividually but also intraindividually, from absence of change to an increase or decrease in most subjects in both study groups. A decrease in sinus rate on appearance of atrioventricular block was found constantly in only two athletes and one control. Atrioventricular dissociation with junctional rhythm occurred in seven athletes (20%) and with ventricular rhythm in one athlete. Neither of these phenomena was seen in the group of controls. The athletes had slightly fewer ventricular extrasystoles than controls, and no athlete had ventricular tachycardia, whereas two controls had ventricular tachycardia.

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Adverse reactions to ophthalmic patients during 9909 fluorescein angiographies during 9 years were registered. Nausea (4.6%) and vomiting (1.3%) wem the most common untoward reactions. Allergic skin manifestations occurred in 48 patients, and 5 patients coniplained of shortness of breath. 56 patients (0.6%) felt dixy during or immediately after the investigation. Nine patients complained of chest pain, three of whom developed myocardial infarction.Sixteen patients collapsed during the procedure. One healthy male, 42-year-old, collapsed after the injection of fluorescein during angiography, and electrocardiogram showed an asystole of 24 seconds. Otherwise, the electrocardiograms registered on 100 consecutive patients did not reveal any systematic changes in heart rate or rhythm during fluorescein angiography.

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There is persisting low use of beta-blocker secondary prophylaxis, particularly in the elderly and in women, not attributable to perceived contraindications or intolerance. Considerable regional variations persist despite shared trials evidence. Discharge treatment strongly influences long-term medication.