1.What is paroxysmal supraventricular tachycardia? Paroxysmal supraventricular tachycardia is a common cardiac arrhythmia, which is a series of clinical manifestations caused by a sudden and rapid acceleration of the heartbeat. It is characterized by a sudden acceleration of the heartbeat without any aura, with a pulse rate of mostly 160 – 240 beats/min and up to 300 beats/min in children, and this heartbeat also returns to normal suddenly. The duration of seizures varies from a few seconds to several days. Most patients can terminate on their own after the onset, and a few patients must be medicated to terminate. 2.What is the radical treatment for paroxysmal supraventricular tachycardia? Transcatheter ablation or surgical treatment is used to achieve radical treatment of supraventricular tachycardia. Preoperative electrophysiological examination should be performed to clarify the mechanism of supraventricular tachycardia generation and to accurately mark the foldback pathway. There are two types of transcatheter ablation: direct current and radiofrequency. The former is very traumatic and can cause rupture of the coronary sinus or atrial muscle, pericardial hemorrhage, pericardial tamponade and serious arrhythmias, so its clinical application is somewhat limited. Radiofrequency ablation is less invasive, the voltage is mostly within 100V, general anesthesia is not required, and there are few serious complications, so it is increasingly used, and satisfactory results have been achieved in the ablation of bypass and slow path of atrioventricular junction area in patients with preexcitation syndrome. Bypass resection requires open-heart surgery. In patients with congenital heart disease complicated by bypass folding supraventricular tachycardia, epicardial bypass markers can be performed simultaneously during cardiac surgery to cut or inject anhydrous alcohol to block the bypass. 3.What is the success rate of radiofrequency ablation for paroxysmal supraventricular tachycardia? Radiofrequency ablation therapy is a more complex interventional therapy, and its success rate and recurrence rate are significantly related to the experience and proficiency of the physician, and the success rate of radiofrequency ablation therapy is very high. In our Cardiac Electrophysiology Center, the success rate for AV node regurgitation tachycardia is 98-99%, and the recurrence rate is less than 2%-10%. Atrioventricular regressive tachycardia has a success rate of 95-99% for left-sided bypass and 85-95% for right-sided and septal bypass. The success rate of atrial tachycardia and atrial flutter is 80-90%. 4.How is the operation procedure of radiofrequency ablation for paroxysmal supraventricular tachycardia? Ablation method: Minimally invasive method is used. The left subclavian vein is punctured under local anesthesia and the coronary sinus electrode is placed. The right femoral vein is punctured and a high right atrial, Hitchcock bundle or right ventricular electrode is placed. The right femoral artery is punctured in the left bypass tract to ablate on the ventricular side of the mitral annulus (an atrial septal puncture can also be used, and a femoral vein-to-left atrial route can be established to achieve ablation of the left free wall atrioventricular bypass tract on the atrial side of the mitral valve. After completion of the intraventricular tube and pre-ablation electrophysiologic evaluation, septal puncture is performed and the large-tipped catheter then enters the left atrium for ablation via the introducer sheath). The right parasternal pathway is ablated on the atrial side of the tricuspid annulus. The dual atrioventricular pathway is ablated on the right atrial side at the mid or inferior septum. Radiofrequency electrical energy 10-50W sustained discharge time 60-90s. 5. What are the possible complications of radiofrequency ablation therapy for paroxysmal supraventricular tachycardia? Possible complications include: local hematoma from vascular puncture, thrombosis, cerebral and lower extremity artery thromboembolism, pulmonary embolism, severe vagal reflex, complete atrioventricular block, cardiac perforation leading to acute cardiac compression, hemothorax, mediastinal hematoma and so on. But in general, the serious complications are extremely low. 6.What is the price of radiofrequency ablation treatment? What are the postoperative problems? Hospitalization, including various tests, medications and equipment, is about 30,000. During the postoperative recovery period, those who puncture the vein should stay in bed for 4-6 hours, and those who puncture the artery should stay in bed for 12-24 hours to avoid prolonged bed rest to avoid deep vein thrombosis. Generally 72 hours can be discharged from the hospital, but do not bear weight or exercise strenuously.