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June 16, 1945

Pre-Excitation, a Cardiac Abnormality: Patho-Physiclogical, Patho-Anatomical and Clinical Studies of an Excitatory Spread Phenomenon Bearing upon the Problem of the WPW (Wolff, Parkinson and White) Electrocardiogram and Paroxysmal Tachycardia

JAMA. 1945;128(7):550-551. doi:10.1001/jama.1945.02860240076032

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This monograph, a supplement to Acta medica Scandinavica, is an excellent translation, by Ulla Schött, of the author's views regarding the WPW syndrome. The report of 70 carefully studied cases with correlated discussion of 250 from the literature reveals his comprehensive knowledge. Since 1930 forty theories have been advanced, fifteen of these since 1940. The term preexcitation indicates an additional excitatory spread in the ventricles of the heart, coupled to the auricular excitation wave; the phenomenon being represented graphically by a short PR interval and a prolonged aberrant QRS complex. The author reports a case with muscle bundle connection of the left auricle and ventricle. A right sided auriculoventricular junction has been reported. Hence such an anomaly could result from the excitation wave being transmitted via both the normal and accessory conduction pathways. He gives reasons for assuming an acquired as well as a congenital etiology in these cases. He

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