Surgical treatment is the method of choice in patients with ventricular tachycardia refractive to drug therapy. Fifty-six patients with ventricular tachycardia of various genesis were examined and separated into two groups according to the main heart disease. Group 1 was formed of patients with ischemic heart disease. In 16 of the 17 patients of this group disorders of left-ventricular contractility were revealed, the ejection fraction varied from 18 to 56% (average 32 +/- 13.8%). The attacks of ventricular tachycardia in patients of group 1 were characterized by an extremely severe course and cardioversion had to be resorted to repeatedly in order to relieve them. Endo- and epicardial mapping revealed localization of the arrhythmogenic focus on the boundary of the myocardial area involved in fibrosis. Surgical treatment was successful in 72% of cases in this group. Group 2 included patients with ventricular tachycardia of noncoronary genesis. In electrophysiological examination tachycardia could not be induced in 6 patients of this group. In 12 of 39 patients attacks of tachycardia were not attended by hemodynamic disorders. Contractility of the left-ventricular myocardium was disturbed only in 14 (36%) patient. The arrhythmogenic focus was in the right ventricle in 22 patients and in the left ventricle in 11 patients. Operation was performed on 29 patients of this group. The arrhythmogenic focus was successfully removed in 79% of cases. Surgical treatment of ventricular tachycardias of various genesis was successful in 76% of cases in follow-up periods of 2 months to 6 years.