title: Nonpharmacologic treatment of supraventricular and ventricular tachyarrhythmias. A review of 249 consecutive patients.
abstract: Incapacitating or life-threatening tachyarrhythmias were treated nonpharmacologically in 249 patients from 1982 to 1991. Among 92 patients surgically treated for supraventricular tachycardia the cure rate was 93% and the complication rate 12%. Radiofrequency catheter ablation gave an equal cure rate in 51 patients, but with no major complications or mortality. Direct-current catheter ablation of the His bundle was successful in 96% of 27 patients with drug-refractory atrial fibrillation or other supraventricular tachyarrhythmias. Among 64 patients undergoing surgery for ventricular tachycardia/ventricular fibrillation, the perioperative mortality was 9%, estimated 5-year survival 69% and estimated 5-year freedom from the preoperative arrhythmias 72%. Of 18 patients treated with implantable cardioverter defibrillator, three (18%) died of heart failure during follow-up. Nonpharmacologic treatment of tachyarrhythmias is concluded to be effective and often definitively curative. The safety-risk ratio is improving as new treatment modalities are developed.
authors.affiliation: Department of Cardiology, Skejby Sygehus, University Hospital, Aarhus, Denmark.
authors.forename: P E
authors.initials: PE
authors.lastname: Thomsen
authors.forename: P K
authors.initials: PK
authors.lastname: Paulsen
authors.forename: O
authors.initials: O
authors.lastname: Kromann
authors.forename: H R
authors.initials: HR
authors.lastname: Andersen
authors.forename: A K
authors.initials: AK
authors.lastname: Pedersen
authors.forename: H
authors.initials: H
authors.lastname: Allermand
authors.forename: P
authors.initials: P
authors.lastname: Mortensen
authors.forename: L
authors.initials: L
authors.lastname: Frost
authors.forename: O
authors.initials: O
authors.lastname: Albrechtsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002036:Bundle of His / Q000601:surgery; D002304:Cardiac Pacing, Artificial / Q000379:methods; D002315:Cardiopulmonary Bypass; D017115:Catheter Ablation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013617:Tachycardia, Supraventricular / Q000601:surgery*; D017180:Tachycardia, Ventricular / Q000601:surgery*; D014693:Ventricular Fibrillation / Q000601:surgery