RT Book, Section A1 Prystowsky, Eric N. A2 Prystowsky, Eric N. A2 Klein, George J. A2 Daubert, James P. SR Print(0) ID 1176522307 T1 Preexcitation Syndromes T2 Cardiac Arrhythmias: Interpretation, Diagnosis, and Treatment, 2e YR 2020 FD 2020 PB McGraw Hill PP New York, NY SN 9781260118209 LK accesscardiology.mhmedical.com/content.aspx?aid=1176522307 RD 2024/03/29 AB There has been a fascination with the preexcitation syndromes that has spanned decades and led to a rich history of discovery (Figure 7-1). Over a century ago investigators began looking into the mechanism of how an atrial impulse activated the ventricle.1 Stanley Kent reported on an atrioventricular (AV) connection in mammalian hearts. This nodelike structure most likely does not represent the AV muscle connection more typically described by anatomists in patients with preexcitation, and Sir Thomas Lewis dismissed this alternative theory of AV conduction. However, Mines was more visionary and postulated the use of this AV connection in a reentrant circuit using the main AV bundle for anterograde activation and the accessory pathway (AP) for retrograde conduction. Electrocardiographic (ECG) evidence of preexcitation was reported by Cohn and Fraser, as well as Wilson, who also demonstrated intermittent preexcitation in one of the figures. The mechanism for the delta wave of preexcitation had several postulates including mechanical, chemical, and electrical. Holzmann and Scherf, and Wolferth and Wood suggested that the abnormal ventricular depolarization was due to conduction over the anomalous AV connection.