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Classical Article
. 2006 Oct;11(4):340-53.
doi: 10.1111/j.1542-474X.2006.00127.x.

Bundle-branch block with short P-R interval in healthy young people prone to paroxysmal tachycardia. 1930

Louis Wolff, John Parkinson, Paul D White
Classical Article

Bundle-branch block with short P-R interval in healthy young people prone to paroxysmal tachycardia. 1930

Louis Wolff et al. Ann Noninvasive Electrocardiol. 2006 Oct.
No abstract available

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Figures

Figure 1
Figure 1
(Case I) Right bundle‐branch block. The P‐R interval is 0.1 second. The rate is 72. Time intervals for this and succeeding figures = 0.2 second. Horizontal lines cut off intervals of 10−4 volt.
Figure 2
Figure 2
(Case I) Immediately after exercise (running up and down four flights of stairs). Sino‐auricular tachycardia, rate 140 to 120. The ventricular complexes are normal, the P‐waves are better marked, and the P‐R interval is 0.16 second.
Figure 3
Figure 3
(Case I) One hour after the subcutaneous injection of 1/30 grain of atropine sulphate. The rate is 140, the ventricular complexes are normal, and the P‐R interval is 0.15 to 0.16 second.
Figure 4
Figure 4
(Case II) Intraventricular block. The P‐R interval is 0.1 second. Rate 96.
Figure 5
Figure 5
(Case II) Immediately after exercise. The ventricular complexes are normal except for deformity of the S wave and S‐T interval by artefact (high resistance, resulting in over‐shooting). The T‐wave is upright. The P‐R interval is 0.15 second. Rate 96.
Figure 6
Figure 6
(Case III) Right bundle‐branch block. The P‐R interval is well under 0.1 second. The rate varies between 60 and 70.
Figure 7
Figure 7
(Case III) After a paroxysm of tachycardia lasting seven hours. The ventricular complexes are normal, but occasionally there is reversion to the abnormal form. The P‐R interval is almost 0.2 second. The P‐waves are notched, and identical in Figs. 6 and 7.
Figure 8
Figure 8
(Case III) Two years after Fig. 6 was taken. Normal physiological curves.
Figure 9
Figure 9
(Case IV) Spontaneous reversion from bundle‐branch block curves to normal ones. The form of the P‐wave remains unaltered, but the P‐R interval changes from 0.09 second to 0.15 second.
Figure 10
Figure 10
(Case IV) Normal physiological complexes. P‐R interval 0.15 second. In Lead II there is a transition to the abnormal form and short P‐R interval.
Figure 11
Figure 11
(Case IV) Bundle‐branch block. The P‐R interval is less than 0.1 second. The P‐waves are identical in Figs. 10 and 11: note the peculiar notching of the P‐waves.
Figure 12
Figure 12
(Case IV) Simultaneous electrocardiogram and jugular and radial tracings. Bundle‐branch block curves are present. The a. c. v. h. sequence is normal.
Figure 13
Figure 13
(Case V) Intraventricular block. The P‐waves are normal and upright in all leads. The P‐R interval is well under 0.1 second.
Figure 14
Figure 14
(Case VI) Intraventricular block. The P‐waves are normal and upright in all leads. The P‐R interval is well under 0.1 second.
Figure 15
Figure 15
(Case VII) Left bundle‐branch block. The P‐waves are normal and upright in all leads. The P‐R interval is well under 0.1 second.
Figure 16
Figure 16
(Case VIII) Right bundle‐branch block. The P‐R interval is well under 0.1 second.
Figure 17
Figure 17
(Case VIII) Three years later. Normal physical curves. The P‐R interval is 0.16 second. The P‐waves are identical in Figs. 16 and 17.
Figure 18
Figure 18
(Case IX) Intraventricular block. The P‐R interval is 0.1 second. Time intervals = 0.2 and 0.04 seconds.
Figure 19
Figure 19
(Case X) Intraventricular block. The P‐R interval is 0.1 second.
Figure 20
Figure 20
(Case XI) Intraventricular block. The P‐R interval is less than 0.1 second.
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References

    1. Carter, E. P .: Clinical Observations on Defective Conduction in the Branches of the Auriculo‐Ventricular Bundle. Arch. Int. Med., 13, 803, 1914.
    1. Cohn, A. E. , and Lewis, T .: The Pathology of Bundle‐Branch Lesions of the Heart. Proc. N. Y. Path. Soc., 14, 207, 1914.
    1. Eppinger, H. , Und Rothberger, J .: Zur Analyse des Elektrokardiogramms. Wien Klin. Wchnschr., 22, 1091,1909.
    1. Eppinger, H. , Und Rothberger, J .: Ueber die Folgen der Durchschneidung der Tawaraschen Schenkel des Reizleitungssystems. Ztschr. f. klin. Med., 70, 1, 1910.
    1. Eppinger, H. , Und Stoerk, O. : Zur Klinik des Elektrokardiogramms. Ztschr. f. klin. Med., 71, 157, 1910.

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