The Wolff-Parkinson-white syndrome and the beginnings of direct arrhythmia surgery.

The bundle of Kent, one of the two pathways involved in the reentry tachycardia of the Wolff-Parkinson-White syndrome, was identified and then interrupted fifteen years ago. This marked the beginning of direct arrhythmia surgery. The patient was a 31-year-old man with a right free wall pathway and persistent tachycardia refractory to medical treatment. In the present report, the historical landmarks in the description of the morphology of the conduction system are reviewed. Current methods of interrupting the Kent bundle, based on experience with more than 200 surgical patients, are discussed. Included is the newer method of simplifying the surgical procedure with cryothermia. Speculation about the future of direct arrhythmia surgery is given in the concluding remarks.