温控与非温控射频导管治疗小儿右侧房室旁道的体会

The experience of treatment for right atrioventricular accessory pathway in children using temperature-controlled and non-temperature-controlled ablation catheter

目的本文评价温控与非温控射频导管治疗小儿右侧房室旁道的疗效。方法1992年3月～1997年4月共应用射频消蚀术治疗小儿右侧房室旁道21例，男9例，女12例，平均年龄7．76岁，分温控及非温控两组，其中温控组6例，非温控组15例。结果温控组与非温控组的放电时间、放电次数、手术时间分别为137．5±52．7秒、5．1±2．2次、1．9±0．9小时及251．5±84．0秒、7．8±5．3次、3．5±1．3小时。结论温控消蚀导管可显著减少放电时间、放电次数及手术时间，无严重并发症，因此，治疗小儿右侧房室旁道时应首选温控消蚀导管。

Objective To evaluate the effect of treatment on right atrioventricular accessorypathway in children by using temperature-controlled and non- temperature-controlled ablationcatheter. Methods 21 children patients with rightatrioventricular accessory pathway (AP) underwent radiofrequency ablation between March 1992 andApril 1997, including nine boys and twelve girlswith a mean age of 7. 76 years old. They were divided into tWo groups, of which one was temperaturecontrolled with 7 An and the other was non- temperature- controlled group with 15 AP. In radiofrequency ablation the catheter tip temperature,impedance, power output, energy delivery pulse andtime were continuously measured, the operation timeand fluoroscopy time were recorded. Results In 21patients there were 22 AP, i. e one has two AP. Theenergy delivery pulses and time, the operation time,the power output, the fluoroscopy time were 137. 5± 52.7 see, 5. 1± 2.2, 1 .9 ± 0.9 hr, 34.6 ± 14.6 w and 31. 6± 16. 3 sec in temperature- controlledgroup, but in non -temperature- controlled groupwere 251 .5 ± 84.0 see, 7.8 ± 5.3 and 3.5± 1.3hr, 35 .4 ± 9.5 and 38 .0 ± 21 .6 sec, respectively.The success rate were 80% and 83. 3%. Conclusion There was no significantly difference betweentemperature- controlled and non - temperaturecontrolled groups. Temperature- controlled ablationcould significantly reduce the energy delivery pulseand time and the operation bine, and avoid the complications caused by higher electrode temperature.Thus, the first choice is temperature- controlledcatheter for children with right atrioventricular accessory pathway.[