European Journal of Cardio-Thoracic Surgery, Vol 3, 392-395, Copyright © 1989 by European Association for Cardio-thoracic Surgery
Surgery for supraventricular tachycardia (SVT)
WG Meldrum-Hanna, DC Johnson and GR Nunn
Department of Cardiothoracic Surgery, Westmead Hospital, Australia.
All forms of supraventricular tachycardia (SVT) are now potentially curable
by surgery and we believe that patients should be offered surgery as an
initial therapeutic option. At Westmead Hospital, 311 patients have
undergone surgery for SVT, 13 having AV node ablation, a procedure now
rarely performed, and 298 have had attempts at curative surgery. One
hundred and ninety-nine patients were diagnosed primarily as having a
Wolff-Parkinson-White syndrome (WPW) and 139 had free wall or anterior
septal connections with a clinical cure rate of 98.0%. The failures were
entirely due to unrecognised posterior septal connections. Sixty patients
had primarily posterior septal connections with a clinical cure rate of
96%. Atrioventricular junctional re-entry tachycardia may now be cured,
probably by dividing an extra nodal His- to-atrial connection.
Seventy-eight patients have undergone surgery with a clinical cure rate of
92%. Fifteen patients with right atrial tachycardias, 4 patients with
nodo-ventricular fibres and 2 with incessant AV tachycardia have undergone
surgery. The overall clinical cure rate for all patients is 95% and 92% at
late electro-physiological study (EPS).
