Role of Surgery in the Treatment of Tachycardias

Abstract

Surgical interventions for correction or palliation of cardiac arrhythmias can be divided conveniently into direct and indirect interventions. The direct operation ablates or isolates a part of the myocardium that contains an automatic focus or reentry circuit, interrupts a pathway involved in a reentry circuit, or partially or completely interrupts the normal conduction system. Indirect interventions include operations in which an artificial device is inserted either as a substitute for a portion of the conduction system, or as a source of stimuli that interrupt or alter the arrhythmia. Other indirect operations are dorsal sympathectomy, coronary artery bypass grafts, and aneurysmectomy. In the following discussion the emphasis will be on direct operations.