Surgical Treatment of Refractory Tachyarrhythmia(Current Topics on Cardiac Arrhythmias)

From 1985 to 1991, we operated on 20 patients with the Wolff-Parkinson-White (WPW) syndrome, one patient with automatic atrial tachycardia and 11 patients with ventricular tachycardia. Eighteen Pateints with WPW syndrome underwent surgical ablation by the endocardial approach and 2 patiens by the epicardial approach. There was no early and late death. Pathway ablation was completely successfl in 18 pationts (90%). One patient with heart failure and long-term incessant atrial tachycardia underwent excision of the atrail aneurysm including the ectopic automatic focus. Of 11 patients with ventricular tchycardia, 2. patients (18%) died in the early postoprative period and 2 patients (18%) died of progessive congesitve heart failure and arrhythmia, respectively, in the late postoperative period. Efficacy of operation for ventricular tachycardia was 73% in the early opstoperative period and 55% in the late postoperative period. Surgical treatment for monofocal ventricular tachycardia achived an exellemt long-time arrhythmia control and operative efficacy was limitted in the patients with multifocal ventricular tachycardia