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When Paul Wood spoke about this to the British Cardiac Society in 1961, we were impressed by the originality of his work on a subject that so many had noticed but failed to investigate. A few months before his death in July 1962, when I asked him if his paper was ready for the journal, he said that he had not yet been able to get all the evidence he hoped for to establish the full explanation. Unfortunately, he had not the time to complete this. I have, therefore, tried to set out as clearly as possible the stage that he had reached.