Early history of the pre-excitation syndrome

This brief review discusses the interesting early history of the pre-excitation syndrome. In 1913 Cohn and Fraser published the first patient with a short P-R interval, wide QRS complexes, and paroxysmal tachycardia. This was followed by other cases of pre-excitation syndrome, all of which were considered to be due to bundle branch blocks. In 1930 Wolff, Parkinson, and White reported 11 patients with the syndrome, which came to bear their name. Two years later, Holzmann and Scherf suggested bypass tracts as the most likely mechanism of pre-excitation syndrome. In 1942, Wood et al. documented the first accessory connection at autopsy. Despite these early studies supporting the bypass theory, the quest for alternative mechanisms continued until the 1970s when electrophysiological studies and surgical therapy confirmed accessory connections as the mechanism of pre-excitation syndrome.