Surgery for cardiac arrhythmias.
From March 1989 to March 1991, 17 patients underwent curative surgical ablation of cardiac arrhythmias at the Singapore General Hospital. In the supraventricular tachycardia group, 13 patients with the Wolff-Parkinson White syndrome (WPW) underwent surgical ablation of the accessory conduction pathway by the classical endocardial approach. Two patients who had atrioventricular nodal tachycardia (AVNRT) underwent surgical dissection around the atrioventricular node to divide one of the dual conduction pathway responsible for the tachycardia. In the ventricular tachycardia group, two patients underwent surgical ablation of the arrhythmic focus. There was no operative mortality in the supraventricular tachycardia group and there were no late deaths to date. All these patients underwent electrophysiological study just before discharge and most of them had a repeat test six months later. In the Wolff-Parkinson White group, surgical ablation was completely successful in 12 patients (92%), preexcitation recurred in one patient (8%) but non had recurrence of supraventricular tachycardia. The two patients who had atrioventricular nodal tachycardia were completely cured of recurrent supraventricular tachycardia and had normal atrioventricular conduction. In the ventricular tachycardia group, one was cured with no recurrence of tachycardia, is not on medication and is in New York Heart Association Class I status. The other died postoperatively of recurrent ventricular tachycardia and low cardiac output syndrome.
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