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Electrocardiographic assessment of repolarization
heterogeneity First Edition Bart Hooft Van Huysduynen
Digital Instant Download
Author(s): Bart Hooft van Huysduynen
ISBN(s): 9789090206165, 9090206167
Edition: first
File Details: PDF, 3.11 MB
Year: 2006
Language: english
Electrocardiographic Assessment

Repolarization Heterogeneity

Bart Hooft van Huysduynen

of

Electrocardiographic Assessment of Repolarization Heterogeneity Bart Hooft van Huysduynen

Electrocardiographic Assessment
of
Repolarization Heterogeneity

Bart Hooft van Huysduynen

Electrocardiographic Assessment
of
Repolarization Heterogeneity

PROEFSCHRIFT
ter verkrijging van
de graad van Doctor aan de Universiteit Leiden
op gezag van de Rector Magnificus Dr. D. D. Breimer,
hoogleraar in de faculteit der Wiskunde en
Natuurwetenschappen en die der Geneeskunde,
volgens besluit van het College voor Promoties
te verdedigen op donderdag 8 juni 2006
te klokke 16.15 uur

door

Bart Hooft van Huysduynen

geboren te Amsterdam
in 1974
Promotiecommissie

Promotores: Prof. dr. M.J. Schalij

Prof. dr. E.E. van der Wall

Co-promoter: Dr. ir. C.A. Swenne

Referent: Prof. dr. N.M. van Hemel (Hart Long Centrum Utrecht,
Nieuwegein)

Overige commissieleden: Prof. dr. A. van der Laarse

Prof. dr. A. van Oosterom (Centre Hospitalier
Universitaire Vaudois, Lausanne)
Dr. H.W. Vliegen
Prof. dr. A.A.M. Wilde (Academisch Medisch
Centrum, Amsterdam)

The research described in this thesis was performed at the Department of Cardiology
of the Leiden University Medical Center, Leiden, the Netherlands

The study described in this thesis was supported by a grant of the Netherlands
Heart Foundation ( NHF-2001B177). Financial support by the Netherlands Heart
Foundation for the publication of this thesis is gratefully acknowledged.
Aan mijn ouders
© 2006 B. Hooft van Huysduynen, Leiden, the Netherlands
All rights reserved. No part of this publication may be reproduced or transmitted in
any form or by any means, electronic or mechanical, including photocopy, recording,
or any information storage and retrieval system, without permission from the
copyright owner.

ISBN: 978-90-9020616-5

Cover image: Scanning electron microscope picture of Purkinje fibers at the

endocardium of the heart (magnification 300x). The electrocardiogram (lead V5) of
dr. P.S. Monraats.

Printed by: Febodruk B.V. te Enschede

Financial contribution to the publication of this thesis was kindly provided by Jacques
H. de Jong Stichting, J.E. Jurriaanse Stichting, St Jude Medical, Siemens, Guidant,
Novartis, Bayer, Schering-Plough, AstraZeneca, Boehringer Ingelheim, Bristol-
Myers Squibb, Servier, Pfizer, Sankyo and Medtronic.
Contents

Chapter 1.
Introduction: Electrocardiographic assessment of 9
repolarization heterogeneity.

Chapter 2.
Validation of ECG indices of ventricular repolarization 43
heterogeneity; A computer simulation study.
J Cardiovasc Electrophysiol 2005; 16: 1097-103

Chapter 3.
Hypertensive stress increases dispersion of repolarization. 65
Pacing Clin Electrophysiol. 2004; 27: 1603-9

Chapter 4.
Increased dispersion of ventricular repolarization during 83
recovery from exercise.
submitted

Chapter 5.
Reduction of QRS duration after pulmonary valve replacement 105
in adult Fallot patients is related to reduction of right ventricular
volume after pulmonary valve replacement in Fallot’s tetralogy.
Eur Heart J 2005; 26: 928-32

Chapter 6.
Pulmonary valve replacement in tetralogy of Fallot improves 117
the repolarization.
submitted

Chapter 7.
Dispersion of the repolarization in cardiac resynchronization 135
therapy.
Heart Rhythm 2005; 2: 1286-93

Chapter 8.
Summary and conclusions 159
Nederlandse samenvatting 164

Dankwoord 168

Curriculum Vitae 169

 Chapter 1

Introduction
Electrocardiographic assessment of
repolarization heterogeneity

9
 Chapter 1

Outline of chapter 1

History of the electrocardiogram and the T wave

The T wave and action potentials
Heterogeneity of the repolarization and arrhythmias
Physiological heterogeneity of repolarization
-Transmural repolarization heterogeneity
-Apico-basal repolarization heterogeneity
Electrocardiographic indices of repolarization heterogeneity
- QT interval
- Tapex-end interval
- QT dispersion
- T-wave amplitude
- T-wave area
- QRS-T angle
- T-wave complexity
- Ventricular gradient
Aim and outline of the thesis

10
 Introduction: Electrocardiographic assessment of repolarization heterogeneity

History of the electrocardiogram and the T wave

The development of electrocardiography has largely taken place in Leiden. Willem

Einthoven was one of the founding fathers of electrocardiography, for which he re-
ceived the Nobel prize in 19241. Einthoven was head of the Leiden University Physi-
ology Laboratory nearby the Academic Hospital2. Initially he improved Lippmann’s
electrometer, which Waller had used to record the first human ECG in 18873. In
1895 Einthoven developed a mathematical formula to construct the actual ECG
from the signal of the slow responsive electrometer. To discern his calculated ECG
from its predecessor, he renamed the ABCD deflections into PQRST (Figure 1a)
4
. These names were universally adopted and are still in use today. He described the
T wave more or less as “ein stumpf und aufwärts gerichte Spitze “. In the following
years Einthoven developed the world famous string galvanometer5, which allowed
recording of high quality, stable electrocardiograms. In 1902 the first so recorded
ECGs were published and the actual shape of the T wave was revealed (Figure 1b)6.

Figure 2a. In 1902 electrocardio-

grams recorded with the string gal-
vanometer were first published. Ein-
Figure 1a. Einthoven calculated the electrocardiogram thoven. In: Herinneringsbundel Prof.
from the signal of the slowly responsive electrometer and Rosenstein 1902.
called the derived deflections PQRST, names that are still
in use today. Einthoven. Pflügers Arch ges Physiol 1895.

11
 Chapter 1

The T wave and action potentials

The T wave depends on differences in timing of the repolarization of myocardial

cells. Schematically, when two action potentials are subtracted, a T-wave emerges7
(Figure 2). The repolarization time of a given myocardial cell consists of the summa-
tion of the activation time and action potential duration (APD).

Figure 2. Schemati-
cally, when two action
potentials are subtract-
ed, a T-wave emerges.
0 = fast depolarizing
upstroke, 1 = initial
rapid recovery phase, 2
= plateauphase, 3 = re-
polarization, 4 = rest-
ing potential. Adapted
from Franz et al. Prog
Cardiovasc Dis 1991.

The primary function of the cardiac electrical system is the coordination of myocar-
dial contraction. After the upstroke of the action potential, myocardial contraction
starts, thereafter the plateau phase of the action potential is responsible for the con-
tinuation of myocardial contraction. In combination with the specific organization
of the myocardial fibers, the contraction of myocardial cells results in a wringing
motion8 of the heart that efficiently propels the blood9. Furthermore, action potential
durations have the tendency to correct for differences in activation time. In general,
the earliest activated regions have the longest action potential duration and the lat-
est activated regions have the shortest action potential duration. These repolarizing
properties result in a more homogeneous repolarization10;11 and relaxation12.

12
 Introduction: Electrocardiographic assessment of repolarization heterogeneity

Heterogeneity of the repolarization and arrhythmias

Besides a direct relation with mechanical function, the shape of the action potential
(AP) also has protective electrophysiological properties.
The relatively long plateau phase of the cardiac action potential prohibits tetanus in
the myocardium, which occurs relatively frequently in skeletal muscle 13.
Furthermore, the tendency of APDs to compensate for different activation times di-
minishes repolarization heterogeneity10;11, which reduces the risk of arrhythmias. Het-
erogeneous repolarization facilitates the formation of functional barriers surrounded
by excitable tissue14;15. Re-entrant arrhythmias may be initiated by an adversely timed
stimulus that reaches such a barrier and circles around it16. As a consequence, abrupt,
local differences in refractoriness facilitate re-entrant arrhythmias. Repolarization
differences between nearby areas are therefore potentially more arrhythmogenic than
repolarization differences between areas more distant from each other (Figure 3).

Figure 3. Disper-
sion in repolariza-
tion or refractoriness
depicted by varying
grey scale in two
simulated fields of
256 (16×16) elec-
trode sites. Lower
panels show histo-
grams of these local
inhomogeneity val-
ues, corresponding
to the two fields.
Arrowheads above
histograms indicate
the values of percen-
tiles P5 ( ► ), P50
( ▼ )(median) and
P95 ( ◄ ).
Although the median dispersion of refractory period is the same in both conditions, the left figure
shows global dispersion, with smoothly changing differences in refractoriness. Only in the right fig-
ure local dispersion exists with possible higher susceptibility to functional barreres and re-entry ar-
rhythmias. Local inhomogeneity values are calculated on the extreme right as the maximum (24 ms,
circled) of absolute differences (4, 10, 18 and 24 ms) within a neighbourhood of four electrode sites.
Adapted from Burton and Cobbe. Cardiovasc Res 2001.

13
 Chapter 1

As can be inferred from the above, repolarization heterogeneity is thus linked to

arrhythmogenesis due to the relationship with refractoriness. When the AP of a
myocardial cell is still in its plateau phase (phase 2) the cell is absolute refractory,
to the contrary, when the cell is fully repolarized (phase 4) the cell is fully excitable.
Any phase in between, on the down slope of the APD (phase 3), will result in a
partially excitable cell, also named the relatively refractory period, during which a
strong stimulus is still able to depolarize the cell17. An exception to these principles
is, for example, post-repolarization refractoriness, which can be present in ischemic
myocardium18. An ischemic cell may be refractory despite having reached phase 4.

Action potentials can be recorded using microelectrodes or monophasic action po-

tential catheters19. The action potential duration is defined as the APD90, which is
the time interval from upstroke of the action potential to the moment when action
potential amplitude has decreased by 90 % of its maximum amplitude. In vivo, repo-
larization studies in animals are mostly performed using needle electrodes allowing
the measurement of activation recovery intervals (ARIs). The ARI is measured from
the negative deflection of the activation complex to the positive deflection of the
repolarization wave on the unipolar electrogram. ARIs are a surrogate measure of
APD, but with a good correlation20;21 between recorded monophasic action poten-
tials and ARIs 20.
As stated before, repolarization heterogeneity may form the substrate for an arrhyth-
mia, but a trigger is also necessary to initiate an arrhythmia. Early after depolariza-
tions may occur in the setting of a disturbed repolarization and may serve as this
trigger. The premature stimulus itself also modifies the repolarization heterogene-
ity22;23. Even in patients without overt structural heart disease, closely coupled, mul-
tiple extrastimuli are able to induce ventricular fibrillation. Arrhythmias can also be
maintained by continuously firing foci24-26.

Physiological heterogeneity of the repolarization

Repolarization heterogeneity is mostly classified in transmural and apico-basal het-

erogeneity. Repolarization heterogeneity between the left and right ventricle also
exists, but data are scarce.

14
 Introduction: Electrocardiographic assessment of repolarization heterogeneity

Transmural repolarization heterogeneity

The nature of the transmural repolarization differences is not entirely clear; some
studies dispute the existence and direction of the transmural repolarization gradi-
ent27;28. The presence or absence and direction of the transmural gradient is essential
for the understanding of the formation of the normal T wave and will be discussed
in detail the following paragraphs.

As early as in 1931 Wilson proposed the existence of a ventricular gradient, caused

by non-homogeneous action potential durations throughout the heart29. Despite op-
posite polarities of de- and repolarization currents, human QRS complexes and T
waves attain the same polarity in most ECG leads. This concordance between QRS
complexes and T waves can be explained by an inverse transmural repolarization
order (from epi-to-endocardium) compared to the excitation order (from endo-to-
epicardium)29;30.

Animal studies
In canines the polarity of T waves can be varied by changing transmural APD differ-
ences by local warming or cooling30. Warming is known to shorten APD and cool-
ing is known to lengthen APD31. Epicardial warming as well as endocardial cool-
ing cause upright, concordant T waves. Endocardial warming and epicardial cooling
cause inverse, discordant T waves30.
Van Dam and Durrer measured refractory periods in dogs and found the short-
est refractory periods in the midwall. Intermediate APDs were recorded from the
endocardium and the longest APDs from the epicardium. They reported negative T
waves in unipolar leads from the epicardial surface32. On the other hand, Burgess et
al. measured longer endocardial than epicardial refractory periods33.
Abildskov studied refractoriness and repolarization times (defined as activation time
plus refractory period) in 15 anesthetized dogs34. In 5 dogs, transmural excitation and
repolarization studies were performed immediately after thoracotomy. Despite an
earlier excitation, the endocardium repolarized later than the epicardium, as reflected
by longer refractory periods and later repolarization times (figure 4).

15
 Chapter 1

Figure 4. Despite an earlier excitation, the endocardium repolarized later than the epicardium, as
reflected by longer refractory periods and later repolarization times. Recovery times are used as a
surrogate for repolarization time (excitation time + refractory period = repolarization time)
Adapted from Abildskov. Circulation 1975.

Spach and Barr used intramural and epicardial electrodes to measure potential dis-
tributions during excitation and repolarization35. Beforehand they recorded ECGs
to ensure positive (concordant) T waves, and excluded several dogs with negative
T waves. Depolarization spread in accordance with the findings of Durrer and co-
workers36 from endo- to epicardium, starting at the left midseptum and ending at the
base. In general, positive potentials were recorded from the epicardium compared to
more negative potentials recorded from the endocardium, implying an earlier epicar-
dial repolarization.
El-Sherif et al. performed 3-D mapping of arrhythmias emerging under long QT
conditions in an in-vivo canine model37. They found that subendocardial focal ac-
tivity can maintain arrhythmias but may result in reentrant arrhythmias when the
repolarization heterogeneity was large enough. Steep transmural differences in ARI
across the wall contributed to this repolarization heterogeneity.
Recently, Janse et al. published a study performed in dogs28 that was in line with the
findings of Janse’s thesis published in 197138. The epicardial repolarization time was
not earlier compared to the endocardial repolarization time. However, the published
canine ECG showed discordant QRS complexes and T waves28 as opposed to the T
and QRS concordance found in humans.
Different species, and more specifically different mammals of different size may show

16
 Introduction: Electrocardiographic assessment of repolarization heterogeneity

either concordance or discordance on their ECG39. In dogs concordance may be ei-

ther present or absent35. In chimpanzees, a species genetically close to humans, con-
cordance is present in most leads40. The ECGs of the giraffe as well as the humpback
whale41 show discordant T waves. Several studies disputing the presence of an epi- to
endocardial transmural repolarization gradient, depicted surface ECGs with discor-
dant ECGs. Results obtained from these species can therefore not be extrapolated
to the human repolarization. Before selecting animals for an invasive repolarization
study, electrocardiograms should be recorded to assure concordant T waves.

Human studies
Franz et al. recorded left ventricular endocardial monophasic action potentials in 7
patients undergoing catheterization (for suspected coronary disease in 5 patients and
aortic disease in 2 patients)10. Additionally, they measured epicardial monophasic
action potentials during surgery for coronary artery bypass grafting in 3 other pa-
tients. To compare endo- and epicardial recovery times in these different patients,
and during different interventions, they normalized the repolarization times (RT =
activation time + APD) of endo-and epicardium on the individual QT intervals on
the surface ECGs. Expressed as percentage of the QT interval, epicardial RTs (71-84
%) were shorter than endocardial RTs (80-98%).
Taggart et al. measured left ventricular ARIs in 21 patients during CABG42. Mea-
surements were performed during right ventricular stimulation at different cycle
lengths and during spontaneous atrial beats. No statistical differences were found
between any of the recording sites. However, when closely observing the transmural
ARI graphs, a trend towards a 5 ms shorter subepicardial ARI than subendocardial
ARI can be detected. Electrograms provided as example show that the epicardial
ARI is 14 ms shorter than the subendocardial ARI. These differences are small but
consistent. Possibly, the interindividual variation in ARI is larger than the intra-
individual variation in transmural ARI, rendering them undetectable by the used
statistical methods. Understandably, Taggart et al. used short needles, the edge of the
deepest electrode reaching only 7.15 mm. The authors state that the first 0.5 to 1.0
mm is epicardial fat, this would mean that the center of the deepest electrode reaches
only to a depth of 6.5 mm from the epicardial myocardial surface. Therefore the en-
docardium is virtually left out of these experiments.

In conclusion, in animal studies the direction of a transmural gradient determines the

17
 Chapter 1

polarity of the T wave. An epi- to endocardial gradient is responsible for concordant

T waves. The results of these animal studies combined with the interpretation of the
above mentioned human studies suggest that a small transmural epi- (early repolar-
ization) to endocardium (later repolarization) repolarization gradient is likely to be
present under physiological conditions in humans.

M-cells
M-cells may play a pivotal role in transmural repolarization heterogeneity43. Part of
the debate on transmural dispersion is the discussion whether M-cells have a signifi-
cant physiological effect on the repolarization.

Yan and Antzelevitch demonstrated the presence of M-cells in a preparation of the

left ventricular free wall43. This preparation was made by dissecting a wedge shaped
part of the left ventricular wall with its supplying large epicardial artery (which was
perfused subsequently). Monophasic action potentials were recorded from epi- and
endocardial cells and from the mid-myocardial cells, which were named: M-cells. The
M-cells in this preparation had the longest APD and the epicardial cells the shortest
APD. The difference in action potential duration and amplitude between these cell
layers mainly determined the morphology of the T wave in a pseudo-ECG recorded
across the wedge preparation. The shorter epicardial APD and earlier repolarization
time resulted in a positive T wave directed towards the epicardium.
Drouin et al. confirmed the presence of M-cells in wedge preparations of 4 appar-
ently healthy human hearts44. M-cells were found 1 mm up to 4-5 mm from the epi-
cardial surface, constituting of approximately 30 % of the myocardial mass. M-cells
demonstrated an increased rate-dependence of their already longer APD duration
during electrical stimulation with 1 to 0.1 Hz. The lower the stimulation frequency,
the longer the APD, thereby increasing transmural repolarization heterogeneity.
Anyukhovsky et al. performed a comparative study of wedge preparations and in vivo
canine hearts45. They measured APDs in transmural wedge preparations and ARIs
in in vivo hearts. In the wedge preparations they found M-cells; midmyocardial cells
with relatively long APDs that were more sensitive to abrupt changes in cycle length
than endo- and epicardial cells. Noteworthy is that the epicardial APD were longer
than endocardial APD. However, they did not find any transmural difference in (av-
eraged) ARIs in vivo, supposedly caused by electrotonic interaction between myocar-

18
 Introduction: Electrocardiographic assessment of repolarization heterogeneity

dial cells. However, in their example an endocardial (shorter repolarization time) to

epicardial (longer repolarization time) gradient was present and accompanied by an
ECG with a discordant T wave.

Conrath and Opthof used (strand-) simulation models to study the effects of electri-
cal coupling on transmural repolarization differences46. Their conclusion is plausible:
in physiological conditions, M-cells do not introduce large transmural repolarization
differences; due to intact electrotonic coupling the repolarization differences become
smaller.

In conclusion, from the wedge preparation studies we know M-cells exist. How-
ever, the electrophysiological significance of M-cells in the normal heart is probably
small. Large, abrupt repolarization differences due to different repolarization prop-
erties of different cells are smoothened by electrotonic interaction with surround-
ing cells. However, arrhythmias mostly emerge under unphysiological conditions.
For example, in heart failure patients connexins are down regulated, which produces
uncoupling between transmural muscle layers leading to marked repolarization het-
erogeneity between epicardial and deeper myocardial layers. Therefore, decreased
connexin expression patterns can potentially contribute to an arrhythmic substrate
in failing myocardium47. Another argument against the functional significance of M-
cells is that APD lengthening appears only at unphysiological slow rates. However,
Torsade de pointes arrhythmias are known to be initiated after a short-long(-short)
sequences48. Thus, arrhythmias mostly emerge under pathological conditions, with
less electrical coupling, greater cycle length changes and adversely timed extrastimuli.
These conditions may increase the electrophysiological expression of M-cells result-
ing in an increase of transmural repolarization heterogeneity to a critical level and an
increased susceptibility to arrhythmias.

19
Other documents randomly have
different content
The Project Gutenberg eBook of The Young
Section-Hand
 This ebook is for the use of anyone anywhere in the United
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Title: The Young Section-Hand

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*** START OF THE PROJECT GUTENBERG EBOOK THE YOUNG

SECTION-HAND ***
THE YOUNG SECTION-HAND
“CAUGHT THE CHILD FROM UNDER THE VERY WHEELS OF THE
ENGINE”
 THE YOUNG
SECTION-HAND
By BURTON E. STEVENSON
Author of “The Holladay Case,” “Tommy
Remington’s Battle,” etc.

ILLUSTRATED BY
L. J. BRIDGMAN

Boston
L. C. PAGE & COMPANY
Mdccccv
 Copyright, 1905
By L. C. Page & Company
(INCORPORATED)
All rights reserved
Published July, 1905
COLONIAL PRESS
Electrotyped and Printed by C. H. Simonds & Co.
Boston, U. S. A.
 TO
E. B. S., G. W. P
AND THE OTHER “BOYS” OF YARD
AND SHOP AND OFFICE
IN MEMORY
OF THAT FAR-OFF TIME
WHEN I “COVERED” THE RAILROAD
 CONTENTS

I. The Bottom Round

II. A New Experience
III. An Adventure and a Story
IV. Allan Meets an Enemy
V. Allan Proves His Metal
VI. Reddy to the Rescue
VII. The Irish Brigade
VIII. Good News and Bad
IX. Reddy’s Exploit
X. A Summons in the Night
XI. Clearing the Track
XII. Unsung Heroes
XIII. A New Danger
XIV. Allan Makes a Discovery
XV. A Shot from Behind
XVI. A Call to Duty
XVII. A Night of Danger
XVIII. The Signal in the Night
XIX. Reddy Redivivus
XX. The Road’s Gratitude
 ILLUSTRATIONS
“Caught the child from under the very wheels of the engine”

“Near at hand it was even more terrifying than at a distance”

“He struck suddenly and viciously at the boy’s face”

“Snatched the little one into the air just as the engine bore down upon it”

“Just in time to escape a large boulder”

“He stepped to one side, and ... brought down his club upon the other’s head”
THE YOUNG SECTION-HAND
 CHAPTER I.
THE BOTTOM ROUND

“Excuse me, sir, but do you need a man?”

Jack Welsh, foreman of Section Twenty-one, on the Ohio division
of the P. & O., turned sharply around at sound of the voice and
inspected the speaker for a moment.
“A man, yes,” he said, at last. “But not a boy. This ain’t boy’s
work.”
And he bent over again to sight along the rail and make sure that
the track was quite level.
“Up a little!” he shouted to the gang who had their crowbars
under the ties some distance ahead.
They heaved at their bars painfully, growing red in the face under
the strain.
“That’ll do! Now keep it there!”
Some of the men braced themselves and held on to their bars,
while others hastened to tamp some gravel solidly under the ties to
keep them in place. The foreman, at leisure for a moment, turned
again to the boy, who had stood by with downcast face, plainly
undecided what to do. Welsh had a kindly Irish heart, which not
even the irksomeness of section work could sour, and he had noted
the boy’s fresh face and honest eyes. It was not an especially
handsome face, yet one worth looking twice at, if only for its
frankness.
“What’s yer name, sonny?” he asked.
“Allan West.”
“An’ where’d y’ come from?”
“From Cincinnati.”
The foreman looked the boy over again. His clothes were good,
but the worn, dusty shoes told that the journey of nearly a hundred
miles had been made on foot. He glanced again at the face—no, the
boy was not a tramp; it was easy to see he was ambitious and had
ideals; he was no idler—he would work if he had the chance.
“What made y’ come all that way?” asked Welsh, at last.
“I couldn’t find any work at Cincinnati,” said the boy, and it was
evident that he was speaking the truth. “There’s too many people
there out of work now. So I came on to Loveland and Midland City
and Greenfield, but it’s the same story everywhere. I got some little
jobs here and there, but nothing permanent. I thought perhaps at
Wadsworth—”
“No,” interrupted the foreman. “No, Wadsworth’s th’ same way—
dead as a doornail. How old’re you?” he asked, suddenly.
“Seventeen. And indeed I’m very strong,” added the boy, eagerly,
as he caught a gleam of relenting in the other’s eye. “I’m sure I
could do the work.”
He wanted work desperately; he felt that he had to have it, and
he straightened instinctively and drew a long breath of hope as he
saw the foreman examining him more carefully. He had always been
glad that he was muscular and well-built, but never quite so glad as
at this moment.
“It’s mighty hard work,” added Jack, reflectively. “Mighty hard. Do
y’ think y’ could stand it?”
“I’m sure I could, sir,” answered Allan, his face glowing. “Just let
me try.”
“An’ th’ pay’s only a dollar an’ a quarter a day.”
The boy drew a quick breath.
“That’s more than I’ve ever made regularly, sir,” he said. “I’ve
always thought myself lucky if I could earn a dollar a day.”
Jack smiled grimly.
“You’ll earn your dollar an’ a quarter all right at this work,” he
said. “An’ you’ll find it’s mighty little when it comes t’ feedin’ an’
clothin’ an’ lodgin’ yerself. But you’d like t’ try, would y’?”
“Yes, indeed!” said Allan.
 There could be no doubting his eagerness, and as he looked at
him, Jack smiled again.
“I don’t know what th’ road-master’ll say; mebbe he won’t let me
keep you—I know he won’t if he sees you can’t do th’ work.” He
looked down the line toward the gang, who stood leaning on their
tools, enjoying the unusual privilege of a moment’s rest. “But I’m a
man short,” he added. “I had t’ fire one this mornin’. We’ll try you,
anyway. Put your coat an’ vest on th’ hand-car over there, git a pick
an’ shovel an’ go up there with th’ gang.”
The boy flushed with pleasure and hurried away toward the hand-
car, taking off his coat and vest as he went. He was back again in a
moment, armed with the tools.
“Reddy, you show him the ropes!” shouted the foreman to one of
the men.
“All roight, sir!” answered Reddy, easily distinguishable by the
colour of his hair. “Come over here, youngster,” he added, as Allan
joined the group. “Now you watch me, an’ you’ll soon be as good a
section-man as they is on th’ road.”
The others laughed good-naturedly, then bent to work again,
straightening the track. For this thing of steel and oak which bound
the East to the West, and which, at first glance, would seem to have
been built, like the Roman roads of old, to last for ever, was in
constant need of attention. The great rails were of the toughest
steel that forge could make; the ties were of the best and soundest
oak; the gravel which served as ballast lay under them a foot deep
and extended a foot on either side; the road-bed was as solid as the
art of man could make it, pounded, tamped, and rolled, until it
seemed strong as the eternal hills.
Yet it did not endure. For every hour of the day there swept over
it, pounding at it, the monstrous freight locomotives, weighing a
hundred tons, marvels of strength and power, pulling long lines of
heavy cars, laden with coal and iron and grain, hurrying to give the
Old World of the abundance of the New. And every hour, too, there
flashed over it, at a speed almost lightning-like, the through
passenger trains—the engines slim, supple, panting, thoroughbred;
the lumbering mail-cars and day coaches; the luxurious Pullmans far
heavier than any freight-car.
Day and night these thousands of tons hurled themselves along
the rails, tearing at them at every curve, pounding them at every
joint. Small wonder that they sometimes gave and spread, or broke
short off, especially in zero weather, under the great pressure. Then,
too, the thaws of spring loosened the road-bed and softened it;
freshets undermined it and sapped the foundations of bridge and
culvert. A red-hot cinder from the firebox, dropped on a wooden
trestle, might start a disastrous blaze. And the least defect meant,
perhaps, the loss of a score of lives.
So every day, over the whole length of the line, gangs of section-
men went up and down, putting in a new tie here, replacing a
defective rail there, tightening bolts, straightening the track, clearing
the ditches along the road of water lest it seep under the road-bed
and soften it; doing a thousand and one things that only a section-
foreman would think needful. And all this that passengers and
freight alike might go in safety to their destinations; that the road, at
the year’s end, might declare a dividend.
There was nothing spectacular about their work; there was no
romance connected with it. The passengers who caught a glimpse of
them, as the train flashed by, never gave them a second thought.
Their clothes were always tom and soiled; their hands hard and
rough; the tugging at the bars had pulled their shoulders over into
an ungraceful stoop; almost always they had the haggard, patient
look of men who labour beyond their strength. But they were cogs in
the great machine, just as important, in their way, as the big fly-
wheel of a superintendent in the general offices; more important,
sometimes, for the superintendent took frequent vacations, but the
section work could not be neglected for a single day.
Allan West soon discovered what soul-racking work it was. To
raise the rigid track a fraction of an inch required that muscles be
strained to bursting. To replace a tie was a task that tried every
nerve and sinew. The sun beat down upon them mercilessly,
bringing out the sweat in streams. But the boy kept at it bravely,
determined to do his part and hold the place if he could. He was
under a good teacher, for Reddy, otherwise Timothy Magraw, was a
thorough-going section-hand. He knew his work inside and out, and
it was only a characteristic Irish carelessness, a certain unreliability,
that kept him in the ranks, where, indeed, he was quite content to
stay.
“Oi d’ want nothin’ else,” he would say. “Oi does me wor-rk, an’
draws me pay, an’ goes home an’ goes t’ sleep, with niver a thing t’
worrit me; while Welsh there’s a tossin’ aroun’ thinkin’ o’ what’s
before him. Reespons’bility—that’s th’ thing Oi can’t stand.”
On the wages he drew as section-hand—and with the assistance,
in summer, of a little “truck-patch” back of his house—he managed
to keep himself and his wife and numerous children clothed; they
had enough to eat and a place to sleep, and they were all as happy
as possible. So that, in this case, Reddy’s philosophy seemed not a
half-bad one. Certainly this freedom from responsibility left him in
perpetual good-humour that lightened the work for the whole gang
and made the hours pass more swiftly. Under his direction, the boy
soon learned just what was expected of him, and even drew a word
of commendation from his teacher.
“But don’t try to do the work all by yourself, me b’y,” he
cautioned, noting Allan’s eagerness. “We’re all willing t’ help a little.
If y’ try t’ lift that track by yerself, ye’ll wrinch y’r back, an’ll be laid
up fer a week.”
Allan laughed and coloured a little at this good-natured raillery.
“I’ll try not to do more than my share,” he said.
“That’s roight!” approved Reddy, with a nod. “Whin each man
does his share, why, th’ wor-rk goes along stiddy an’ aisy. It’s whin
we gits a shirker on th’ gang like that there Dan Nolan—”
A chorus of low growls from the other men interrupted him.
Nolan, evidently, was not a popular person.
“Who was he?” asked Allan, at the next breathing-spell.
“He’s th’ lazy hound that Jack fired from th’ gang this mornin’,”
answered Reddy, his blue eyes blazing with unaccustomed wrath.
“He’s a reg’lar bad ’un, he is. We used t’ think he was workin’ like
anything, he’d git so red in th’ face, but come t’ find out he had a
trick o’ holdin’ his breath t’ make hisself look that way. He was allers
shirkin’, an’ when he had it in fer a feller, no trick was too mean or
dir-rty fer him t’ try. Y’ remimber, boys, whin he dropped that rail on
poor Tom Collins’s foot?”
The gang murmured an angry assent, and bent to their work
again. Rod by rod they worked their way down the track, lifting,
straining, tamping down the gravel. Occasionally a train thundered
past, and they stood aside, leaning on their tools, glad of the
moment’s rest. At last, away in the distance, Allan caught the faint
sound of blowing whistles and ringing bells. The foreman took out
his watch, looked at it, and closed it with a snap.
“Come on, boys,” he said. “It’s dinner-time!”
They went back together to the hand-car at the side of the road,
which was their base of supplies, and slowly got out their dinner-
pails. Allan was sent with a bucket to a farmhouse a quarter of a
mile away to get some fresh water, and, when he returned, he found
the men already busy with their food. They drank the cool water
eagerly, for the hot sun had given them a burning thirst.
“Set down here,” said the foreman, “an’ dip in with me. I’ve got
enough fer three men.”
And Allan sat down right willingly, for his stomach was protesting
loudly against its continued state of emptiness. Never did cheese,
fried ham, boiled eggs, bread, butter, and apple pie taste better. The
compartment in the top of the dinner-pail was filled with coffee, but
a share of this the boy declined, for he had never acquired a taste
for that beverage. At last he settled back with a long sigh of content.
“That went t’ th’ right place, didn’t it?” asked Jack, with twinkling
eyes.
“That it did!” assented Allan, heartily. “I don’t know what I’d have
done if you hadn’t taken pity on me,” he added. “I was simply
starving.”
“You had your breakfast this mornin’, didn’t y’?” demanded Jack,
sharply.
Allan coloured a little under his fierce gaze.
 “No, sir, I didn’t,” he said, rather hoarsely. “I couldn’t find any
work to do, and I—I couldn’t beg!”
Jack looked at him without speaking, but his eyes were
suspiciously bright.
“So you see, I just had to have this job,” Allan went on. “And now
that I’ve got it, I’m going to do my best to keep it!”
Jack turned away for a moment, before he could trust himself to
speak.
“I like your grit,” he said, at last. “It’s th’ right kind. An’ you won’t
have any trouble keepin’ your job. But, man alive, why didn’t y’ tell
me y’ was hungry? Jest a hint would ’a’ been enough! Why, th’ wife’ll
never fergive me when she hears about it!”
“Oh,” protested Allan, “I couldn’t—”
He stopped without finishing the sentence.
“Well, I’ll fergive y’ this time,” said Jack. “Are y’ sure y’ve ate all y’
kin hold?”
“Every mite,” Allan assured him, his heart warming toward the
friendly, weather-beaten face that looked at him so kindly. “I couldn’t
eat another morsel!”
“All right, then; we’ll see that it don’t occur ag’in,” said Jack,
putting the cover on his pail, and then stretching out in an easier
position. “Now, d’ y’ want a stiddy job here?” he asked.
“If I can get it.”
“I guess y’ kin git it, all right. But how about your home?”
“I haven’t any home,” and the boy gazed out across the fields, his
lips quivering a little despite his efforts to keep them still.
The foreman looked at him for a moment. There was something
in the face that moved him, and he held out his hand impulsively.
“Here, shake!” he said. “I’m your friend.”
The boy put his hand in the great, rough palm extended to him,
but he did not speak—his throat was too full for that.
“Now, if you’re goin’ t’ stay,” went on the other, “you’ve got t’ have
some place t’ board. I’ll board an’ room y’ fer three dollars a week. It
won’t be like Delmonicer’s, but y’ won’t starve—y’ll git yer three
square meals a day. That’ll leave y’ four-fifty a week fer clothes an’
things. How’ll that suit y’?”
The boy looked at him gratefully.
“You are very kind,” he said, huskily. “I’m sure it’s worth more
than three dollars a week.”
“No, it ain’t—not a cent more. Well, that’s settled. Some day,
maybe, you’ll feel like tellin’ me about yerself. I’d like to hear it. But
not now—wait till y’ git used t’ me.”
A freight-train, flying two dirty white flags, to show that it was
running extra and not on a definite schedule, rumbled by, and the
train-crew waved their caps at the section-men, who responded in
kind. The engineer leaned far out the cab window and shouted
something, but his voice was lost in the roar of the train.
“That’s Bill Morrison,” observed Jack, when the train was past.
“There ain’t a finer engineer on th’ road. Two year ago he run into a
washout down here at Oak Furnace. He seen it in time t’ jump, but
he told his fireman t’ jump instead, and he stuck to her an’ tried to
stop her. They found him in th’ ditch under th’ engine, with his leg
mashed an’ his arm broke an’ his head cut open. He opened his eyes
fer a minute as they was draggin’ him out, an’ what d’ y’ think he
says?”
Jack paused a moment, while Allan listened breathlessly, with
fast-beating heart.
“He says, ‘Flag Number Three!’ says he, an’ then dropped off
senseless ag’in. They’d forgot all about Number Three, th’ fastest
passenger-train on th’ road, an’ she’d have run into them as sure as
shootin’, if it hadn’t been fer Bill. Well, sir, they hurried out a flagman
an’ stopped her jest in time, an’ you ort t’ seen them passengers
when they heard about Bill! They all went up t’ him where he was
layin’ pale-like an’ bleedin’ on th’ ground, an’ they was mighty few of
th’ men but what was blowin’ their noses; an’ as fer the women,
they jest naturally slopped over! Well, they thought Bill was goin’ t’
die, but he pulled through. Yes, he’s still runnin’ freight—he’s got t’
wait his turn fer promotion; that’s th’ rule o’ th’ road. But he’s got th’
finest gold watch y’ ever seen; them passengers sent it t’ him; an’
right in th’ middle of th’ case it says, ‘Flag Number Three.’”
Jack stopped and looked out over the landscape, more affected by
his own story than he cared to show.
As for Allan, he gazed after the fast disappearing train as though
it were an emperor’s triumphal car.
 CHAPTER II.
A NEW EXPERIENCE

“When I was a kid,” continued Welsh, reminiscently, after a

moment, “I was foolish, like all other kids. I thought they wasn’t
nothin’ in th’ world so much fun as railroadin’. I made up my mind t’
be a brakeman, fer I thought all a brakeman had t’ do was t’ set out
on top of a car, with his legs a-hangin’ over, an’ see th’ country, an’
wave his hat at th’ girls, an’ chase th’ boys off th’ platform, an’ order
th’ engineer around by shakin’ his hand at him. Gee whiz!” and he
laughed and slapped his leg. “It tickles me even yet t’ think what an
ijit I was!”
“Did you try braking?” asked Allan.
“Yes—I tried it,” and Welsh’s eyes twinkled; “but I soon got
enough. Them wasn’t th’ days of air-brakes, an’ I tell you they was
mighty little fun in runnin’ along th’ top of a train in th’ dead o’
winter when th’ cars was covered with ice an’ th’ wind blowin’ fifty
mile an hour. They wasn’t no automatic couplers, neither; a man had
t’ go right in between th’ cars t’ drop in th’ pin, an’ th’ engineer
never seemed t’ care how hard he backed down on a feller. After
about six months of it, I come t’ th’ conclusion that section-work was
nearer my size. It ain’t so excitin’, an’ a man don’t make quite so
much money; but he’s sure o’ gettin’ home t’ his wife when th’ day’s
work’s over, an’ of havin’ all his legs an’ arms with him. That counts
fer a whole lot, I tell yer!”
He had got out a little black pipe as he talked, and filled it with
tobacco from a paper sack. Then he applied a lighted match to the
bowl and sent a long whiff of purple smoke circling upwards.
“There!” he said, leaning back with a sigh of ineffable content.
“That’s better—that’s jest th’ dessert a man wants. You don’t smoke,
I guess?”
 “No,” and Allan shook his head.
“Well, I reckon you’re as well off—better off, maybe; but I begun
smokin’ when I was knee high to a duck.”
“You were telling me about that engineer,” prompted Allan, hoping
for another story. “Are there any more like him?”
“Plenty more!” answered Jack, vigorously. “Why, nine engineers
out o’ ten would ’a’ done jest what he done. It comes nat’ral, after a
feller’s worked on th’ road awhile. Th’ road comes t’ be more t’ him
than wife ’r childer—it gits t’ be a kind o’ big idol thet he bows down
an’ worships; an’ his engine’s a little idol thet he thinks more of than
he does of his home. When he ain’t workin’, instead of stayin’ at
home an’ weedin’ his garden, or playin’ with his childer, he’ll come
down t’ th’ roundhouse an’ pet his engine, an’ polish her up, an’ walk
around her an’ look at her, an’ try her valves an’ watch th’ stokers t’
see thet they clean her out proper. An’ when she wears out ’r breaks
down, why, you’d think he’d lost his best friend. There was old Cliff
Gudgeon. He had a swell passenger run on th’ east end; but when
they got t’ puttin’ four ’r five sleepers on his train, his old engine was
too light t’ git over th’ road on time, so they give him a new one—a
great big one—a beauty. An’ what did Cliff do? Well, sir, he said he
was too old t’ learn th’ tricks of another engine, an’ he’d stick to his
old one, an’ he’s runnin’ a little accommodation train up here on th’
Hillsboro branch at seventy-five a month, when he might ’a’ been
makin’ twict that a-handlin’ th’ Royal Blue. Then, there’s Reddy
Magraw—now, t’ look at Reddy, y’ wouldn’t think he was anything
but a chuckle-headed Irishman. Yet, six year ago—”
Reddy had caught the sound of his name, and looked up
suddenly.
“Hey, Jack, cut it out!” he called.
Welsh laughed good-naturedly.
“All right!” he said. “He’s th’ most modest man in th’ world, is
Reddy. But they ain’t all that way. There’s Dan Nolan,” and Jack’s
face darkened. “I had him on th’ gang up till this mornin’, but I
couldn’t stan’ him no longer, so I jest fired him. That’s th’ reason
there was a place fer you, m’ boy.”
 “Yes,” said Allan, “Reddy was telling me about him. What was it
he did?”
“He didn’t do anything,” laughed Jack. “That was th’ trouble. He
was jest naturally lazy—sneakin’ lazy an’ mean. There’s jest two
things a railroad asks of its men—you might as well learn it now as
any time—they must be on hand when they’re needed, an’ they
must be willin’ t’ work. As long as y’re stiddy an’ willin’ t’ work, y’
won’t have no trouble holdin’ a job on a railroad.”
Allan looked out across the fields and determined that in these
two respects, at least, he would not be found wanting. He glanced
at the other group, gossiping together in the shade of a tree. They
were not attractive-looking, certainly, but he was beginning to learn
already that a man may be brave and honest, whatever his
appearance. They were laughing at one of Reddy’s jokes, and Allan
looked at him with a new respect, wondering what it was he had
done. The foreman watched the boy’s face with a little smile,
reading his thoughts.
“He ain’t much t’ look at, is he?” he said. “But you’ll soon learn—if
you ain’t learnt already—that you can’t judge a man’s inside by his
outside. There’s no place you’ll learn it quicker than on a railroad.
Railroad men, barrin’ th’ passenger train crews, who have t’ keep
themselves spruced up t’ hold their jobs, ain’t much t’ look at, as a
rule, but down at th’ bottom of most of them there allers seems t’ be
a man—a real man—a man who don’t lose his head when he sees
death a-starin’ him in th’ face, but jest grits his teeth an’ sticks to his
post an’ does his duty. Railroad men ain’t little tin gods nor plaster
saints—fur from it!—but they’re worth a mighty sight more than
either. There was Jim Blakeson, th’ skinniest, lankest, most woe-
begone-lookin’ feller I ever see outside of a circus. He was brakin’
front-end one night on third ninety-eight, an’—”
From afar off came the faint blowing of whistles, telling that, in
the town of Wadsworth, the wheels in the factories had started up
again, that men and women were bending again to their tasks, after
the brief noon hour. Welsh stopped abruptly, much to Allan’s
disappointment, knocked out his pipe against his boot-heel, and rose
quickly to his feet. If there was one article in Welsh’s code of honour
which stood before all the rest, it was this: That the railroad which
employed him should have the full use of the ten hours a day for
which it paid. To waste any part of that time was to steal the
railroad’s money. It is a good principle for any man—or for any boy—
to cling to.
“One o’clock!” he cried. “Come on, boys! We’ve got a good stretch
o’ track to finish up down there.”
The dinner-pails were replaced on the hand-car and it was run
down the road about half a mile and then derailed again. The
straining work began; tugging at the bars, tamping gravel under the
ties, driving new spikes, replacing a fish-plate here and there. And
the new hand learned many things.
He learned that with the advent of the great, modern, ten-
wheeled freight locomotives, all the rails on the line had been
replaced with heavier ones weighing eighty-five pounds to the yard,
—850 pounds to their thirty feet of length,—the old ones being too
light to carry such enormous weights with safety. They were called
T-rails, because, in cross-section, they somewhat resembled that
letter. The top of the rail is the “head”; the thinner stem, the “web”;
and the wide, flat bottom, the “base.” Besides being spiked down to
the ties, which are first firmly bedded in gravel or crushed stone, the
rails are bolted together at the ends with iron bars called “fish-
plates.” These are fitted to the web, one on each side of the junction
of two rails, and bolts are then passed through them and nuts
screwed on tightly.
This work of joining the rails is done with such nicety, and the
road-bed built so solidly, that there is no longer such a great rattle
and bang as the trains pass over them—a rattle and bang formerly
as destructive to the track as to the nerves of the passenger. It is
the duty of the section-foreman to see that the six or eight miles of
track which is under his supervision is kept in the best possible
shape, and to inspect it from end to end twice daily, to guard against
any possibility of accident.
 As the hours passed, Allan’s muscles began to ache sadly, but
there were few chances to rest. At last the foreman perceived that
he was overworking himself, and sent him and Reddy back to bring
up the hand-car and prepare for the homeward trip. They walked
back to where it stood, rolled it out upon the track, and pumped it
down to the spot where the others were working, Reddy giving Allan
his first lesson in how to work the levers, for there is a right and
wrong way of managing a hand-car, just as there is a right and
wrong way of doing everything else.
“That’s about all we kin do to-day,” and Jack took out his watch
and looked at it reflectively, as the car came rolling up. “I guess we
kin git in before Number Six comes along. What y’ think?” and he
looked at Reddy.
“How much time we got?” asked the latter, for only the foreman
of the gang could afford to carry a watch.
“Twelve minutes.”
“That’s aisy! We kin make it in eight without half-tryin’!”
“All right!” and Jack thrust the watch back into his pocket. “Pile
on, boys!”
And pile on they did, bringing their tools with them. They seized
the levers, and in a moment the car was spinning down the track.
There was something fascinating and invigorating in the motion. As
they pumped up and down, Allan could see the fields, fences, and
telegraph-poles rushing past them. It seemed to him that they were
going faster even than the “flier.” The wind whistled against him and
the car jolted back and forth in an alarming way.
“Hold tight!” yelled Reddy, and they flashed around a curve,
across a high trestle, through a deep cut, and down a long grade on
the other side. Away ahead he could see the chimneys of the town
nestling among the trees. They were down the grade in a moment,
and whirling along an embankment that bordered a wide and placid
river, when the car gave a sudden, violent jolt, ran for fifty feet on
three wheels, and then settled down on the track again.
“Stop her!” yelled the foreman. “Stop her!”
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