儿童快速房性心律失常的射频消融治疗

Catheter ablation of atrial tachyarrhythmia in children

对传统方法和CARTO系统在指导导管射频消融儿童快速房性心律失常中的临床应用作初步探讨 ,前者为局灶性房速常规采用激动标测方法 ,后者则应用CARTO系统分别标测I型房扑和房缺在术后疤痕介导房内折返性房性心动过速靶点 ,并在房扑消融后重建三维电解剖图 ,判定峡部完全双向传导阻滞。结果显示3例成功消融 ,曝光时间(18±9)min。随访1月～3月无复发。由此经临床证实导管射频消融儿童快速房性心律失常安全有效 ,尤其对复杂快速房性心律失常 ,CARTO系统能在较少X线曝光下 ,易于标测和成功消融。

As a preliminary approach,the study is to introduce the clinical application and its role of traditional method and using CARTO system for electro_anatomical mapping and ablation of atrial tachyarrhythmia in children,with the former,1 case of atrial tachycardia was mapped by activation during the presence of tachycardia,and the latter was used in 2 cases separately with typical atrial flutter and intra_atrial reentry tachycardia after patch repairment of ASD,in which CARTO system provided a real_time dimensional image of right atrium and guide catheter mapping ablation.After the child with atrial flutter was ablated,electro_anatomical maps were created respectively to assess the bidirectional conduction block.All 3 cases were successfully ablated with 18±9 min of fluoroscopic exposure time.Moreover,no reoccurrence could be observed during follow_up period of 1 to 3 months.In conclusion,the authors claim that it is safe and effective for mapping and ablation of atrial tachyarrhythmia in children using traditional method and CARTO system.Particularly in cases of complex atrial tachyarrhythmia,the optimal target site is easily marked to ablate successfully with less fluoroscopic exposure and it could significantly decrease reoccurrent events.