射频消蚀治疗儿童室上性心动过速

RADIOFREQUENCY ABLATION IN CHIL-DREN WITH SUPRAVENTRICULARTACHY- CARDIA

以射频消蚀（ｒａｄｉｏｆｒｅｑｕｅｎｃｙａｂｌａｔｉｏｎ，ＲＦＡ）治疗儿童室上性心动过速（ＳＶＴ）４６例。左侧房室旁路２５条，右侧旁路１２条。其中右前间隔旁路３条，右后间隔旁路５条，右侧游离壁旁路４条，共３７条旁路。除１例右侧游离壁旁路阻断失败外，其余全部成功。本组改良房室结双径路（ＡＶＮＤＰ）９例，其中８例慢径，１例快径，改良全部成功。总平均累积电能为１５２７７±３５６Ｊ，平均输出功率为１９．０±１．８Ｗ，平均放电次数为８．９±１．２（２～４０）次，平均消蚀时程为１．４１±０．１６（０．５～４．７）小时。无严重并发症，随访５个月～３年无复发，成功率为９７．８％。证明ＲＦＡ是治疗儿童ＳＶＴ有效、安全可靠的根治手段。

adiofrequency ablation(RFA)was performed in46 cases with supraventricular tachycardia(SVT).The total number of the accessory pathway was 37,which included 25 left side accessory pathways and 12right side accessory pathways(3 right anterioseptal, 5right posterioseptal and 4 right free wall). All the ac-cessory pathways were successfully ablated except forone(right free wall accessory pathway).RFA was alsosuccessfully used in all the 9 children with atrioven-tricular nodal reentrant tachycardia, 8 of whom re-ceived selective RFA for slow pathway and 1 case re-ceived selective RFA for fast pathway. The average ofthe total dellvery energy was 15277±356 J with theaverage of the power 19. 0±1. 8W. The average num-ber of energy delivery was 8. 9±1. 2 (2～40). And theaverage duration of the procedure was 1. 41 ± 0. 16(0. 5～4. 7) hours; The rate of success was 97. 8%with no severe complications. There was no relapseduring 5 month to 3 years followup. We conclude thatRFA is an effective and safe way to cure the childrenwith SVT with careful selection of indication.