Nonpharmacologic treatment of supraventricular and ventricular tachyarrhythmias. A review of 249 consecutive patients.
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.
Thomsen
P E
PE
Department of Cardiology, Skejby Sygehus, University Hospital, Aarhus, Denmark.
Paulsen
P K
PK
Kromann
O
O
Andersen
H R
HR
Pedersen
A K
AK
Allermand
H
H
Mortensen
P
P
Frost
L
L
Albrechtsen
O
O
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