[Non-pharmacologic treatment of arrhythmia: what the general practitioner should know]

Important advances have been made in the field of supraventricular and ventricular tachycardias. Catheter ablation procedures are potentially curative in many patients suffering of supraventricular tachycardias. The technique uses radiofrequency current. This form of energy is already very familiar to surgeons. Expected benefits as well as potential complications have to be discussed with the patient prior to the ablation procedure. The automatic internal defibrillator has been commercially available since the end of the eighties. It delivers electrical therapy in case of ventricular malignant arrhythmias, for instance ventricular fibrillation. The sudden death rate is markedly reduced in implanted patients. The long term prognosis however remains critically dependent of the left ventricular function and possible progressive heart failure. Reimbursement depends on pre-implant agreement by the Social Security. At the present time, no reimbursement is provided for prophylactic indications. These two techniques facilitates the treatment of patients previously described as "resistant cases".