[Non-pharmacologic treatment of pre-excitation syndromes]

Paroxysmal tachyarrhythmias due to accessory atrioventricular pathways are usually not completely suppressible with antiarrhythmic drug therapy. These patients can be treated by implantable antitachycardia pacemakers or surgical or catheter ablation of accessory pathways. The antitachycardia pacemaker offers a symptomatic treatment, which is indicated in patients with less often arrhythmias, without atrial fibrillation and with haemodynamically stable tachycardias. The surgical interruption of accessory pathways depends on thoracotomy and often the cardiopulmonary bypass. This therapy is a curative treatment, which is indicated in patients with further cardiac disease needing surgical intervention. Catheter ablation of accessory pathways with radiofrequency energy is the modern treatment. Our own experience with 12 patients with preexcitation syndrome and antitachycardia pacemakers, 50 patients with surgical interruption of accessory conduction and 63 patients with catheter ablation is referred and the results are discussed.