[Electrophysiologic operations. Surgical treatment of life-threatening tachycardia: indications, surgical possibilities, results].

Electrophysiologic operations, which mean electrophysiologically (= mapping)-guided direct operations for life-threatening tachyarrhythmias have been elaborated and popularized during the decade of 1980-1990. They are predominantly related to patients with supraventricular tachycardias on the basis of accessory atrioventricular bypass tracts (Wolff-Parkinson-White syndrome) and individuals with malignant ventricular tachycardias in the setting of coronary artery disease. The concept of these operations is to identify the tachycardia underlying morphologic substrates at time of surgery utilizing intraoperative electrophysiologic mapping techniques and to ablate those arrhythmogenic tissues surgically. In comparison to the natural (= non-surgical) history of the mentioned disorders their mortality and morbidity prognosis is significantly improved through direct antitachycardiac operations. Possibly the spectrum, indications and applications of those electrophysiologic operations will change through the next decade since the meantime a variety of rhythm disorders are successfully approached by interventional cardiologic measures.