Catheter ablation and surgery for arrhythmias.
The technique of ablation was originally developed in the surgical theater and later extended to the catheterization laboratory.  The technique of DC ablation, or fulguration, was the first ablative catheter technique to demonstrate its feasibility.  New techniques using radiofrequency current look promising.  The radiofrequency ablation seems more effective now than at its inception, especially since the introduction of the long-tip electrode and steerable catheters.  These techniques are most effective in experienced hands.  They have proved to reduce mortality as well as morbidity, to decrease the cost of medical therapy, and to reduce the hospital stay.  However, the long-term outcome of radiofrequency is not completely known.  Surgery is still used in patients who have a second indication for a surgical approach and remains the most effective method for the treatment of ventricular tachycardia.  Surgery also remains on the forefront of research, as illustrated by the new approaches to the treatment of atrial fibrillation.  However, in the future, modified techniques based on new catheters or different energies will be used for the complete treatment of a large population of patients with cardiac arrhythmias.
Hôpital Jean Rostand, Ivry-sur-Seine, France.
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D001145:Arrhythmias, Cardiac / Q000601:surgery*; D004564:Electrocoagulation / Q000379:methods*; D004594:Electrophysiology; D006801:Humans