RADIOFREQUENCY CATHETER ABLATION AND IMPL ANTABLE ATRIAL DEFIBRILLATORS IN SUPRAVENTRICULAR TACHYCARDIAS

Non-pharmacological tools for treatment of supraventricular tachycardi as include radiofrequency catheter ablation, antiarrhythmic surgery, a nd electrical therapies. Radiofrequency catheter ablation is the first choice in the treatment of symptomatic patients with AV nodal reentra nt tachycardias and atrioventricular reentrant tachycardias because of its high success rate and its low complication rate. Furthermore, tra nsvenous radiofrequency catheter ablation may considered as a curative approach in patients with atrial flutter in patients with ectopic atr ial tachycardias. Whereas the application of radiofrequency catheter a blation for the curative treatment of atrial fibrillation is still exp erimental, palliative therapy modalities such as AV nodal modification of AV nodal ablation may be performed in patients with drug refractor y atrial fibrillation with rapid ventricular response. The recurrence rate of atrial fibrillation is in the range of 40 to 60% within a year despite antiarrhythmic drug treatment. Internal atrial fibrillation i s a safe and effective method for acute termination of atrial fibrilla tion, especially after unsuccessful external cardioversion. The electr otherapy with the implantable atrial defibrillator should be considere d as an alternative approach in patients with symptomatic, long lastin g, and drug refractory episodes of atrial fibrillation. This innovativ e electrotherapeutic tool is currently under clinical evaluation. For the selection of the most appropriate therapy, the risk-benefit-ratio has to be taken into account in each individual patient.