CARTO3系统指导下射频消融治疗儿童房室结折返性心动过速

Guided radiofrequency ablation using CARTO3 system for atrioventricular nodal reentrant tachycardia in children

目的探索儿童射频消融治疗房室结折返性心动过速(AVNRT)的安全方法。方法回顾分析2014年1月至2017年4月在CARTO 3系统指导下射频消融治疗的80例AVNRT患儿的临床资料。结果 80例AVNRT患儿中,男48例、女32例,平均年龄(11.74±2.49)岁;平均体质量(42.19±12.97)kg,6例(7.5%)体质量<27 kg。患儿治疗中曝光时间(6.87±7.09)min,曝光量(10.71±7.02)m Gy,手术时间(80.81±29.14)min。成功率98.75%(1/80),复发率1.25%(1/80),并发症发生率1.25%(1/80),无死亡病例。结论严格把握手术适应症,在CARTO3系统指导下,结合解剖和电生理方法,采用能量滴定法对儿童进行射频消融治疗AVNRT安全有效。

Objective To explore the safe method of radiofrequency catheter ablation(RFCA)for treatment of atrioventricular nodal reentrant tachycardia(AVNRT)in children.Methods The clinical data of 80 AVNRT children who received RFCA under the guidance of CARTO3 system from January 2014 to April 2017 were retrospective analyzed.Results Eighty AVNRT children(48 boys and 32 girls)had an average age of 11.74±2.49 years and mean weight of 42.19±12.97 kg.The weight of 6 cases(7.5%)was less than 27 kg.The average fluoroscopy time during the treatment was 6.87±7.09 min with radiation doses at 10.71±7.02 mGy and procedure time at 80.81±29.14 min.The immediate successful rate was 98.75%(1/80).The recurrence rate was 1.25%(1/80)during follow-up and the complication rate was 1.25%(1/80),and there was no death case.Conclusions Under the guidance of the CARTO3 system,combined with anatomical and electrophysiological methods,energy titration approach of RFCA is safe and effective treatment of AVNRT.