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[预激综合征简史]

[A concise history of the Wolff-Parkinson-White syndrome].

作者信息

Fazekas Tamás

机构信息

1st Department of Internal Medicine, Szeged University Medical School, Hungary.

出版信息

Orvostort Kozl. 2006;51(3-4):5-22.

Abstract

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.

摘要

在一篇题为《健康年轻人中易发生阵发性心动过速的伴有短P-R间期的束支传导阻滞》(《美国心脏杂志》1930年;第5卷:685 - 704页)的论文中,路易斯·沃尔夫医生(1898 - 1972)、约翰·帕金森爵士(1885 - 1976)和保罗·达德利·怀特医生(1886 - 1973)描述了一种复杂的综合征。此前的病例报告已经指出了该病症的要点,自莱文和比森发表论文(《美国心脏杂志》1941年;第22卷:401 - 409页)以来,它就一直以该名称(WPW综合征)为人所知。长期以来人们认为,第一例具有短PR间期、δ波引起的QRS波群增宽和阵发性室上性心动过速(PSVT)的患者是由科恩和弗雷泽在英国伦敦由托马斯·刘易斯爵士(1881 - 1945)编辑的著名心脏病学杂志上描述的(《心脏》1913/1914年;第5卷:93 - 107页)。此后不久,匈牙利佩奇大学医学院的创办人兼院长扬诺斯·安扬医生(1886 - 1969)也在德国期刊《心脏与血管疾病中央杂志》上发表了一例明确的间歇性WPW综合征病例(1914年;第6卷:345 - 349页)。事实上,安扬应该被视为第一位持续研究心脏病和心律失常的匈牙利“心脏病专家”。最近,由于罗斯托克的格奥尔格·冯·克诺勒医生的研究活动(《心律失常》2005年;第28卷:228 - 230页),我们了解到最早记录的伴有心室预激和PSVT(“心脏跳动”)的心电图病例是由奥古斯特·霍夫曼(1862 - 1929)于1909年11月2日发表在《慕尼黑医学周刊》(第56卷:2259 - 2262页;图10和11)上。霍夫曼是一名内科医生/神经科医生,曾任德国杜塞尔多夫大学医院院长。1967年,西利及其在杜克大学医学中心的同事首次成功地对房室旁道(肯特束)进行了手术切断,这开启了通过射频交流电或如今的经静脉冷冻消融导管技术对WPW患者进行治愈性经导管消融的现代时代。我们目前的知识和日常临床实践是许多国家众多不同学科的杰出科学家做出巨大贡献的结果。

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