Diagnosis and cure of supraventricular tachycardia

The seminal work of Dr Mel Scheinman marked the onset of the era of catheter ablation, a major advance in the management of patients with various arrhythmias. 1 Scheinman M.M. Morady F. Hess D.S. et al. Catheter-induced ablation of the atrioventricular junction to control refractory supraventricular arrhythmias. JAMA. 1982; 248: 851-855 Crossref PubMed Scopus (594) Google Scholar In the early 1980s, direct current (DC) shocks were initially used to create third-degree atrioventricular (AV) block in patients with atrial fibrillation and an uncontrolled ventricular rate or drug-refractory AV nodal reentrant tachycardia associated with severe symptoms. Targets for DC ablation gradually expanded to include posteroseptal accessory pathways (APs) and ventricular tachycardia, both idiopathic and postinfarction. A small number of electrophysiologists also started using DC ablation in the coronary sinus or at the atrial or ventricular aspect of the mitral annulus to target left-sided APs and along the tricuspid annulus to target right-sided APs. The widespread use of DC ablation was limited by the risk of complications caused by barotrauma.