Correction of reentrant atrioventricular tachycardia by surgical ablation of accessory pathways

Patients with reentrant atrioventricular (AV) tachycardia have an accessory connection in addition to the normal conduction pathway, AV node and His-Purkinje system. This pathway predisposes some patients to recurrent, disabling supraventricular tachyarrhythmias. Although it is found with other associated cardiac conditions, most patients are healthy with no underlying structural heart disease. Interest has developed in surgically dividing the accessory pathway in patients with arrhythmias poorly controlled with medications or at risk for potentially fatal tachyarrhythmias. Surgery is safe and effective and should be considered for patients with rapid AV conduction during atrial fibrillation, those refractory to pharmacologic therapy, and young patients who otherwise would require lifelong antiarrhythmic therapy. This report describes surgical correction of reentrant AV tachycardia in five patients ranging in age from six months to 23 years.