[The therapeutic approach in refractory supraventricular tachycardias].

In recent years, considerable progress has been achieved on the understanding of the mechanisms of the different supraventricular tachyarrhythmias. These advances have led to the development of rational procedures that can effectively cure most of the patients. Radiofrequency catheter ablation is highly effective in supraventricular tachycardia, with favorable cost-benefit analysis compared to lifelong antiarrhythmic drug therapy and should be considered as an initial option. In atrial fibrillation, only few patients are currently considered for non-pharmacologic therapeutic modalities, but this number should grow as this is the area of most promising research and the one expected to make more progress in the years to come.