Surgery of tachycardic cardiac arrhythmias. Surgical treatment of life threatening tachycardias: indications, surgical possibilities, results
Ostermeyer, J.; Simic, O.
Therapeutische Umschau. Revue Therapeutique 49(8): 565-579
1992
ISSN/ISBN: 0040-5930 PMID: 1519186 Document Number: 401502
Electrophysiologic operations for surgical treatment of malignant tachyarrhythmias include a preoperative electrophysiologic study (EPS) to assess the characteristics and dignity of the arrhythmia, intraoperative electrophysiologic mapping to identify and localize the arrhythmogenic morphologic substrate, surgical ablation of the arrhythmogenic tissues, and early postoperative EPS to evaluate the result of the operation and the post-surgical prognosis. The majority of patients undergoing an electrophysiologic operation suffer from supraventricular tachyarrhythmias due to accessory atrioventricular bypass tracts (Wolff-Parkinson-White syndrome) and malignant ventricular tachycardias in the setting of coronary artery disease. In comparison of the natural (non-surgical) history of those rhythm problems their prognosis as regards mortality and morbidity is significantly improved by operation. Possibly the spectrum and the role of electrophysiologic antiarrhythmic surgery will be changed during the next decade by the increasing application of interventional cardiologic measures as catheter ablation (PTCA) thrombolysis.