Gallagher J J
Am J Cardiol. 1978 May 22;41(6):1035-44. doi: 10.1016/0002-9149(78)90855-x.
A variety of surgical interventions have evolved for the treatment of intractable or life-threatening arrhythmias unresponsive to conventional pharmacologic or pacemaker therapy. Supraventricular arrhythmias associated with rapid ventricular responses can be indirectly treated with ablation of the atrioventricular conduction system and insertion of a pacemaker. Ventricular tachyarrhythmias have previously been treated with sympathectomy, resection of tissue or revascularization. More recent approaches include the simple ventriculotomy, encircling endocardial ventriculotomy, cryosurgical ablation and insertion of the automatic implantable defibrillator. Refinement of methods to localize more precisely the origin of ventricular arrhythmias may allow design of more direct surgical procedures. The surgical treatment of arrhythmias related to the preexcitation syndromes remains the model of electrophysiologic surgery. It is now feasible to divide accessory pathways with a high degree of success and at low risk in selected patients.
针对传统药物治疗或起搏器治疗无效的顽固性或危及生命的心律失常，已经出现了多种外科干预措施。与快速心室反应相关的室上性心律失常可通过房室传导系统消融和起搏器植入进行间接治疗。室性快速心律失常以前曾采用交感神经切除术、组织切除术或血管重建术进行治疗。最近的方法包括单纯心室切开术、心内膜环行心室切开术、冷冻手术消融和植入自动植入式除颤器。更精确地定位室性心律失常起源的方法的改进可能会促使设计出更直接的外科手术。与预激综合征相关的心律失常的外科治疗仍然是电生理手术的典范。现在，在选定的患者中成功地切断附加通路并使其风险较低是可行的。
