[Endocavitary ablation: a new therapeutic approach to supraventricular tachycardia]

Nowadays patients suffering from supraventricular tachycardia are first treated with antiarrhythmic drugs. In refractory cases alternative treatment is antitachycardia pacemaker implantation or surgery. Recently new percutaneous catheter techniques have been developed to ablate directly the anatomical substrate responsible for the arrhythmia by delivering energy (high or low energy shock or radiofrequency) at the tip of a catheter. This article summarizes the results of clinical application of these different techniques and briefly presents our experience. The very recent studies with RF in patients with drug-refractory av nodal reentry or accessory pathway related tachycardia (WPW syndrome) report a success rate of 92-99% with a very low complication rate. If the long term success of radiofrequency is confirmed this technique will emerge in the near future as the treatment of choice in patients suffering from symptomatic supraventricular tachycardia, since it avoids expensive, longlasting drug treatment with the permanent risk of side effects.