SHORT AND LONG-TERM RESULTS OF SURGERY FO R SUPRAVENTRICULAR ARRHYTHMIAS - A RETROSPECTIVE STUDY

The results of surgical procedures for treatment of supraventricular t achycardias were assessed in 65 patients undergoing operation between January, 1980 and December, 1993. Indications for intervention were WP W (59 patients), atrial fibrillation (5 patients) and atrial flutter ( 1 patient). All cases of WPW were refractory to medical treatment and 14 of 58 patients had one or several syncopes, 4 of whom had to be sus citated. The surgical treatment of these patients was dissection of an accessory atrioventricular pathway. 15 of these patients underwent he art operation for a different indication at the same time. A total of 60 accessory pathways were diagnosed preoperatively, while 4 were loca ted intraoperatively. The reoperation rate was 3% (2 patients) due to persistent WPW. Incidence of total AV block after the operation was 7% (4 patients). In the late postoperative stage, 12 patients developed supraventricular tachycardias, but none of these cases required surgic al treatment. The actuarial survival rate after 10 years was 100%, and after 14 years 96%. We conclude that surgical dissection of accessory pathways offers a good alternative in cases of unsuccessful catheter ablative procedures or in cases of concomitant heart surgery. In 6 pat ients with mitral valve surgery, associated chronic atrial fibrillatio n was found. A concomitant Maze-procedure was performed for the purpos e of surgically converting the atrial fibrillation to a stable sinus r hythm. The early postoperative results are promising.