The Wolff-Parkinson-White Syndrome

Perspective1 August 1969The Wolff-Parkinson-White SyndromeTHOMAS N. JAMES, M.D., F.A.C.P.THOMAS N. JAMES, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-71-2-399 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn a very real sense one may look on the Wolff-Parkinson-White (WPW) syndrome as the Rosetta stone of electrocardiography, since a full understanding of all its features and their possible mechanisms encompasses many fundamentally important principles. In any discussion of this syndrome it is essential to keep in mind that the original descriptions included not only the characteristic QRS complex of ventricular preexcitation but also paroxysmal arrhythmias and excessive numbers of premature beats. There is furthermore the long-known but poorly understood influence of vagus nerve stimulation, which paradoxically may either precipitate or terminate an arrhythmia in the syndrome. Because of...References1. DURRER D and ROOS JP: Epicardial excitation of the ventricles in a patient with Wolff-Parkinson-White syndrome (type B). Circulation 35: 15, 1967. CrossrefMedlineGoogle Scholar2. DURRER D, SCHOO L, SCHUILENBURG RM, and WELLENS HJ: The role of premature beats in the initiation and the termination of supraventricular tachycardia in the Wolff-Parkinson-White syndrome. Circulation 36: 644, 1967. CrossrefMedlineGoogle Scholar3. DURRER D: Electrical aspects of human cardiac activity: a clinical-physiological approach to excitation and stimulation. Cardiovasc. Res. 2: 1, 1968. CrossrefMedlineGoogle Scholar4. BURCHELL HB, FRYE RL, ANDERSON WM, and MCGOON DC: Atrioventricular and ventriculoatrial excitation in Wolff-Parkinson-White syndrome (type B). Temporary ablation at surgery. Circulation 36: 663, 1967. CrossrefMedlineGoogle Scholar5. COBB FR, BLUMENSCHEIN SD, SEALY WC, BOINEAU JP, WAGNER GS, and WALLACE AG: Successful surgical interruption of the bundle of Kent in a patient with Wolff-Parkinson-White syndrome. Circulation 38: 1018, 1968. CrossrefMedlineGoogle Scholar6. DREIFUS LS, NICHOLS H, MORSE D, WATANABE Y, and TRUEX R: Control of recurrent tachycardia of Wolff-Parkinson-White syndrome by surgical ligature of the A-V bundle. Ibid., p. 1030. Google Scholar7. EDMONDS JH, ELLISON RG, and CREWS TL: Surgical induced A-V block as treatment for recurrent atrial tachycardia in Wolff-Parkinson-White syndrome. Ibid., p. 70. Google Scholar8. LEV M, LEFFLER WB, LANGENDORF R, and PICK A: Anatomic findings in a case of ventricular pre-excitation (WPW) terminating in complete atrioventricular block. Circulation 34: 718, 1966. CrossrefMedlineGoogle Scholar9. JAMES TN: The connecting pathways between the sinus node and the A-V node and between the right and the left atrium in the human heart. Amer. Heart J. 66: 498, 1963. CrossrefMedlineGoogle Scholar10. HOLSINGER JW, WALLACE AG, and SEALY WC: The identification and surgical significance of the atrial internodal conduction tracts. Ann. Surg. 167: 447, 1968. CrossrefMedlineGoogle Scholar11. JAMES TN and SHERF L: Ultrastructure of the human atrioventricular node. Circulation 37: 1049, 1968. CrossrefMedlineGoogle Scholar12. JAMES TN: Morphology of the human atrioventricular node, with remarks pertinent to its electrophysiology. Amer. Heart J. 62: 756, 1961. CrossrefMedlineGoogle Scholar13. SHERF L and JAMES TN: A new electrocardiographic concept: synchronized sinoventricular conduction. Dis. Chest 55: 127, 1969. CrossrefMedlineGoogle Scholar14. KENT AF: Researches on the structure and function of the mammalian heart. J. Physiol. 14: 233, 1893. CrossrefGoogle Scholar15. KENT AF: The structure of the cardiac tissues at the auriculoventricular junction. J. Physiol. 47: 17, 1913-1914. Google Scholar16. KENT AF: Observations on the auriculoventricular junction of the mammalian heart. Quart. J. Exp. Physiol. 7: 193, 1914. CrossrefGoogle Scholar17. HOLZMANN M and SCHERF D: Über Elektrokardiogramme mit verkürzter Vorhof-kammertdistanz und positiven P-Zacken. Zeitschrift F. Klin. Med. 121: 404, 1932. Google Scholar18. WOLFERTH CC and WOOD FC: The mechanism of production of short PR intervals and prolonged QRS complexes in patients with undamaged hearts: hypothesis of an accessory pathway of auriculoventricular conduction (bundle of Kent). Amer. Heart J. 8: 297, 1933. CrossrefGoogle Scholar19. WOOD FC, WOLFERTH CC, and GECKELER GD: Histologic demonstration of accessory muscular connections between auricle and ventricle in a case of short PR interval and prolonged QRS complex. Amer. Heart J. 25: 454, 1943. CrossrefGoogle Scholar20. BUTTERWORTH JS and POINDEXTER CA: Short PR interval associated with a prolonged QRS complex. Arch. Intern. Med. (Chicago) 69: 437, 1942. CrossrefGoogle Scholar21. JAMES TN and SPENCE CA: Distribution of Cholinesterase within the sinus node and AV node of the human heart. Anat. Rec. 155: 151, 1966. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: THOMAS N. JAMES, M.D., F.A.C.P.Affiliations: Birmingham, AlabamaFrom the University of Alabama Medical Center, Birmingham, Ala.Supported in part by grants HE-11310 and PH-43-67-1441, U. S. Public Health Service, Washington, D. C.Requests for reprints should be addressed to Thomas N. James, M.D., University of Alabama Medical Center, Birmingham, Ala. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWPW syndrome: the 'Rosetta stone' of rhythmology. The history of the Rosetta stoneLiteraturCoexistence of the Wolff-Parkinson-White Syndrome and Atrioventricular Nodal BlockWolff-Parkinson-White (Type B), Ebstein's anomaly, and congenital ichthyosisDirect Demonstration of Pure Infranodal Preexcitation (Mahaim Conduction) By A-V nodal and His Bundle ElectrographyControl of tachyarrhythmias associated with Wolff-Parkinson-White syndrome by amiodarone hydrochlorideManifestation of the Wolff-Parkinson-White syndrome after myocardial infarctionAtrioventricular and intraventricular conductionPre-excitation with Normal PR IntervalsElectrophysiological Studies on Preexcitation in the Dog Using an Electronically Simulated Atrioventricular Bypass PathwayDisabling Supraventricular Tachycardia of Wolff-Parkinson-White Syndrome (Type A) Controlled by Surgical A-V Block and a Demand Pacemaker after Epicardial Mapping StudiesThe Wolff-Parkinson-White syndrome in advanced atrioventricular blockThe Wolff-Parkinson-White syndrome: Evolving concepts of its pathogenesisHis Bundle Recordings in Patients with Reciprocating Tachycardias and Wolff-Parkinson-White Syndrome 1 August 1969Volume 71, Issue 2Page: 399-405KeywordsArrhythmiaElectrocardiographyMedical servicesNerves ePublished: 1 December 2008 Issue Published: 1 August 1969 PDF downloadLoading ...