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Focal atrial tachyardia constitutes more than 10% of the supraventricular tachycardias and it could be responsible for the initiation of other atrial arrhythmias, like atrial fibrillation and atrial flutter. Frequently, the focal atrial tachycardia does not respond to the medical treatment, while a definitive cure is often obtained with radiofrequency transcatheter ablations and integrated minimally-invasive approaches (atrial appendage clip). This paper describes physiopathological mechanisms underlying the focal atrial tachycardia, its anatomical localizations, the clinical patterns and the fundamentals of the diagnosis. Finally, the more recent treatment strategies will be illustrated and discussed.

Congestive heart failure is a major public health problem in western countries. Although substantial efforts have been made in the last decades in the prevention, diagnosis and treatment of cardiovascular disease, the incidence of end-stage dilated cardiomyopathy is still increasing. Heart transplantation represents the most effective therapy in this setting, but due to shortage of donors, it remains a realistic option just for a very small number of patients. Therefore, conventional surgical treatment for end-stage heart disease has gained increasing attention in recent years and a variety of surgical interventions have been improved or optimized to manage the multifactorial pathophysiology of the heart failure picture. The aim of this review is to report our experience with more than 500 patients with advanced dilated cardiomyopathy, treated with conventional surgical procedures such as myocardial revascularization, left ventricular restoration, mitral valve repair and surgical ablation of atrial fibrillation. Indications, results, controversial issues and future perspectives will be discussed.