[Surgical treatment of arrhythmias]

Recently, many types of pacemakers and the surgical interventions based on the fundamental research have been introduced for the treatment of various arrhythmias which are classified as brady- and tachyarrhythmias. In general selection of pacemaker for bradyarrhythmias, VVI pacemaker is used for the patients with atrial fibrillation. However, a more appropriate pacing therapy for this disease would be VVIR. For sick sinus syndrome with normal atrioventricular conduction, AAIR mode is best. DDDR pacemakers are more appropriate for use in the patients with atrioventricular conduction disturbances. A number of surgical procedures been developed specifically for the purpose to abolish refractory tachyarrhythmias. Especially refractory ischemic ventricular tachyarrhythmias (VT) are more difficult to treat surgically than supraventricular tachyarrhythmias. Our operative results indicate that the recurrence of VT results almost in postoperative death in the patients with pleomorphic VT. The direct operation including the implantation of AICD should be considered mainly for those patients. In this field, we considered the progressive ME devices to be essential for the continued improvement of the results.