[The surgical treatment of pre-excitation syndromes]

In the recent years the approach to the patients with tachycardias due to the Wolff-Parkinson-White (WPW) syndrome has changed in relation to the favourable results obtained by the surgical treatment. In this review the significance of the pre-operative electrophysiologic study is analyzed, as to a guide to localize the accessory pathway and, in particular, to disclose the presence of complicated substrates, such as multiple accessory pathways, AV nodal reentry; these latter situations if not correctly diagnosed, are a cause of surgical failure. We report the use of the epicardial surgical approach (Guiraudon technique). With the recent modifications, this technique avoids in the most cases the use of extracorporeal circulation. This simplified and safe surgical technique is a suitable alternative to other therapeutic strategies.