When is surgery indicated for the control of supraventricular tachycardia?

The surgical treatment of supraventricular tachycardias, if the experience with the ones caused by Kent bundles is excluded, is only now developing. Recent reports have described eight patients who had ablation, excision, or exclusion of an area of myocardium that contained an automatic focus. One instance of partial atrioventricular node interruption has been reported for correction of an atrioventricular nodal reentry tachycardia. The largest group of patients subjected to a direct operation had interruption of atrioventricular conduction. Twenty-seven patients, most of whom had enhanced atrioventricular nodal conduction, had either His bundle ablation or division. Experiments on the supraventricular conduction system have been outlined; they may point the way to extension of the indications for direct operations for supraventricular tachycardia.