射频导管消融治疗儿童室上性心动过速100例体会

The Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Children: Results in 100 Consecutive Patients

经射频导管消融（ＲＦＣＡ）治疗３．５～１４岁儿童阵发性室上性心动过速（ＰＳＶＴ）１００例，探讨ＲＦＣＡ治疗儿童ＰＳＶＴ的安全性及疗效。１００例中房室折返性心动过速（ＡＶＲＴ）７９例，慢－快型房室结折返性心动过速（ＡＶＮＲＴ）２１例。首次消融成功９６例（９６％）。失败４例均为ＡＶＲＴ。平均Ｘ线曝光时间１９ｍｉｎ。除２例ＡＶＮＲＴ放置导管过程中发生一过性ＩＩ度房室阻滞（ＡＶＢ）外，余术中和术后均无并发症发生。术后随访１个月～４．５年，ＡＶＲＴ复发１例，ＡＶＮＲＴ复发４例（占２１例的１９％），总复发率５％。结论：①ＲＦＣＡ治疗儿童ＰＳＶＴ安全、有效。②因儿童的ＡＶＮＲＴ消融慢径易出现ＡＶＢ且复发率高，应严格掌握手术适应证。③术中Ｘ线曝光时间应＜４０ｍｉｎ。

The purpose of this study was to investigate the curative effect and safety factor in children undergoing radiofrequency catheter ablation (RFCA) of supraventricular tachycardia (SVT).One hundred children aged from 3.5 to 14 years underwent RFCA procedures for cure of SVT,including accessory pathways in 79 children and slow fast atrioventricular node reentrant tachycardia(AVNRT) in 21 children.The initial success rate for ablation was 96 percent.In 4 children RFCA of an accessory pathway failed.Average fluoroscopy time was 19 minutes.No complications were noted except that transient complete AV block were induced in 2 children with AVNRT.The total recurrence rate was 5 percent (5 of 100 children) in the duration of follow up of 1 month to 4.5 years,including accessory pathway in 1(1.3%) of 79 children and AVNRT in 4 (19%) of 21.Conclusion:(1)In children,RFCA for cure of SVT are effective and safe.(2)These results suggest that ablation of AVNRT has a high recurrence rate and complication rate in pediatric patients,so the indications should be selected strictly.(3)Fluoroscopy time should be limited within 40 minutes.