小儿室上性心动过速射频消融术后复发相关因素分析

Analysis of recurrence of paroxysmal supraventricular tachycardia in children after radiofrequency catheter ablation

目的:探讨小儿室上性心动过速射频消融术后复发情况,并对复发相关因素进行总结分析。方法:对135例房室结折返性心动过速(AVNRT)及房室折返性心动过速(AVRT)患者经射频消融(RFCA)术后的电生理检查、消融参数及消融终点判断等资料进行总结,回顾性分析其复发情况及原因。结果:135例患者中复发11例,复发率为8.15%。其中AVNRT复发率为6.45%(4/62),AVRT复发率为9.59%(7/73)。4例AVNRT复发者中2例术后慢径残存,73例AVRT患儿复发7例,其中右旁道复发5例,左室旁道复发2例。结论:慢径残存是AVNRT术后复发最主要的原因;旁道未彻底阻断是AVRT术后复发最主要原因。

Objective：To analyze the recurrence of supraventricular Tachycardia（SVT）in children after Radiofrequency Catheter Ablation（RFCA）,and to analysis recurrence-relative factors.Method：The 135 cases with atrioventricular nodal reentrant tachycardia（AVNRT）and artrioventricular reentrant tachycardia（AVRT）after RFCA were followed up and their electrophysiologic data,ablation parameters and ablation endpoint were summarized.The factors of recurrence were analyzed retrospectively.Result：Of the 135,11 cases had recurrence（8.15%）.There were 62 cases of atrioventricular nodal reentrant tachycardia（AVNRT）and 73 causes of artrioventricular reentrant tachycardia（AVRT）.The recurrence rate was 6.45%（4cases）in patients with AVNRT,and 2of the 4recurrent causes with slow pathway remnant,9.59%（7cases）in patients with AVRT.The 5cases were with right accessory pathway（AP）,and 2cases with left AP.Conclusion：Slow pathway remnant is the key factor of AVNRT recurrence after RFCA.Incompletely blocking may lead to recurrence of AVRT after RFCA.