[A concise history of the Wolff-Parkinson-White syndrome].
In a paper entitled Bundle-branch block with short P-R interval in healthy young people prone to paroxysmal tachycardia (Am Heart J 1930; 5: 685-704), Dr. Louis Wolff (1898-1972), Sir John Parkinson (1885-1976) and Paul Dudley White (1886-1973) described an intricate syndrome. Prior case reports had already pointed out the essentials of this entity, which has borne the eponym (WPW syndrome) since the publication by Levine and Beeson (Am Heart J 1941; 22: 401-409). It was long thought that the first patient with a short PR interval, delta-wave-induced widening of the QRS complex and paroxysmal supraventricular tachycardia (PSVT) was described by Cohn and Fraser in the prestigious cardiological journal edited by Sir Thomas Lewis (1881-1945) in London, UK (Heart 1913/1914; 5: 93-107). Shortly afterwards, Dr János Angyán (1886-1969), a school-founder chairman of medicine (1923-1959) at the University of Pécs, Hungary, also published a clear-cut case of intermittent WPW syndrome in the German periodical Zentralblatt für Herz- und Gefässkrankheiten (1914; 6: 345-349]. In fact, Angyán should be considered the first Hungarian "cardiologist" who dealt steadily with heart diseases and rhythm disturbances. Quite reently, thanks to the activities of Dr Georg von Knorre, Rostock (PACE 2005; 28: 228-230) we have learnt that the earliest documented case of ECGs with ventricular preexcitation and PSVT ("Herzjagen") was published by August Hoffmann (1862-1929) in the 2 Nov 1909 issue of Münchener Medizinische Wochenschrift (56: 2259-2262; Figures 10 and 11). Hoffmann worked as an internist/neurologist and was director of the university hospital in Düsseldorf, Germany. The first successful surgical division of an atrioventricular accessory pathway (bundle of Kent), by Sealy and his coworkers at the Duke University Medical Center in 1967, led to the modern era of curative transcatheter ablation for WPW patients by radiofrequency alternative current or, nowadays, by transvenous cryoablative catheter techniques. Our current knowledge and day-to-day clinical practice is the result of marvelous contributions from numerous dedicated scientists in diverse disciplines in many countries.
Fazekas
Tamás
T
1st Department of Internal Medicine, Szeged University Medical School, Hungary. fat@in1st.szote.u-szeged.hu
D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D018156:Journalism, Medical; D014927:Wolff-Parkinson-White Syndrome / Q000266:history* / Q000503:physiopathology / Q000601:surgery