Diagnosis and Cure of the Wolff-Parkinson-White Syndrome or Paroxysmal Supraventricular Tachycardias during a Single Electrophysiologic Test

THE therapeutic options in patients with the Wolff—Parkinson—White syndrome or other paroxysmal supraventricular tachycardias have included antiarrhythmic-drug therapy on an empirical basis or as guided by electropharmacologic testing, 1 2 3 antitachycardia pacemakers, 4 , 5 curative surgical procedures, 6 7 8 9 10 and catheter ablation of the atrioventricular junction followed by the implantation of a permanent pacemaker. 11 Recently, catheter ablation techniques have been developed to treat atrioventricular nodal reentrant tachycardia (the most common type of paroxysmal supraventricular tachycardia) and the Wolff—Parkinson—White syndrome. Direct-current countershocks or radiofrequency current delivered through an electrode catheter has been used either to eliminate atrioventricular nodal reentry without interrupting atrioventricular conduction 12 13 14 or to ablate accessory . . .