食管心房调搏术在婴幼儿心律失常中的应用

Using of transesophageal atrial pacing in infants with arrhythmia

目的探讨食管心房调搏术(TEAP)在婴幼儿心律失常中的应用价值。方法选取我院2010年6月至2017年12月收治的60例心律失常患儿,其中男33例,女27例,年龄33d～3岁,予食管心房调搏进行电生理检查。结果确诊34例(56.7%)为房室折返性心动过速,8例(13.3%)为慢快型房室结折返型心动过速,4例(6.7%)为房性心动过速,2例(3.3%)为心房扑动,7例(11.7%)为室性心动过速,2例(3.3%)为心室预激,3例(5%)为房早未下传和其他。34例房室折返性心动过速和8例房室结折返性心动过速患儿均经食管心房调搏成功复律,其中1例房室折返性心动过速复律成功后仍有复发,患儿口服抗心律失常药物维持窦律,停药观察无复发后出院。7例室速、3例自律性房速未能复律。10例房室折返性心动过速和2例房室结折返型心动过速通过射频消融术成功根治。结论 TEAP可用于婴幼儿心律失常诊断、分型、复律,是一种安全无创性技术,值得临床推广。

Objective To explore the application value ofusing transesophageal atrial pacing(TEAP)in infants with arrhythmia. Methods Selected 60 infants consisted of 33 male and 27 female at the age of 33 days to 3 year old hospitalized infants with arrhythmia from June 2010 to December 2017 under electrocardiograph check. Results Within those 60 infants with arrhythmia, 34 infants(56.7%) are atrioventricular reciprocating tachycardia. where 8 cases(13.3%) are Fast/slow form are atrioventricular reciprocating tachycardia. 4 infants(6.7%) are atrial tachycardia. 2infants(3.3%) are auricular flutter.7 infants(11.7%)were ventricular tachycardia, 2 infants(3.3%) were ventricular preexcitation.The remaining 3 samples are atrial premature or others. Those 34 sample sizes of AVRT and 8 sample sizes AVNRT both can successful cardioversionvia TEAP, while one of infant relapse and treated after taking antiarrythmic drug. 7 infants with ventricular tachycardia and 3 infants with self-regulatory atrial systole failed to recover. 10 cases of AVRT and 2 cases of AVNRT were successfully treated by radiofrequency ablation and no repalse was found when follow-up those infants. Conclusions TEAP can be used for the diagnosis, classification, cardioversion and treatment of infantile arrhythmia. It is a safe and non-invasive technique which worth to promot in clinical.