Ebstein畸形合并预激综合征的射频消融治疗

Radiofrequency catheter ablation for Ebstein anomaly combined with pre-excitation syndrome

目的探讨对Ebstein畸形合并预激综合征采用射频消融治疗的临床效果。方法我院2009年1月至2019年11月收治Ebstein畸形患者101例,将其中9例合并预激综合征并进行了射频消融治疗的患者作为Ebstein组,另外选择同期行射频消融的25例心脏结构正常的B型预激综合征患者作为对照组。比较2组患者的手术时间、消融时间、放电次数、放电功率及临床疗效。结果Ebstein组9例患者的10条旁路被成功消融,其中有3例患者选用Swartz鞘辅助使消融电极贴靠稳定而完成手术;对照组25例患者均顺利完成消融,效果满意。Ebstein组患者手术时间、消融时间、放电次数和放电功率均大于对照组,差异有统计学意义(P<0.05)。Ebstein组患者平均随访(64.44±34.85)个月,对照组患者平均随访(53.12±13.83)个月,2组均无手术并发症发生,均无复发病例。结论与心脏结构正常的预激综合征患者相比,Ebstein畸形合并预激综合征患者行射频消融治疗可取得同样的临床效果,但手术时间、消融时间、放电次数和放电功率会增加。

Objective To investigate the clinical effect of radiofrequency catheter ablation in treatment of Ebstein anomaly combined with pre-excitation syndrome.Methods There were 101 cases of Ebstein anomaly patients treated in our hospital from January 2009 to November 2019.Of whom 9 patients with Ebstein anomaly combined with pre-excitation syndrome underwent radiofrequency catheter ablation were selected as the Ebstein group,and 25 patients of type B pre-excitation syndrome with normal heart structure underwent radiofrequency catheter ablation were selected as the control group.The operation time,ablation time,times of discharge,discharge power and clinical efficacy between two groups were compared. Results In the Ebstein group,10 bypasses of 9 patients were successfully ablated, Swartz sheath was used in 3 patients to stabilize the ablation electrode.In the control group,25 patients successfully completed ablation with satisfactory results.Compared with the control group,the operation time,ablation time,times of discharge,and discharge power of the patients in the Ebstein group were increased or prolonged,and there were statistical differences between the two groups( P <0.05).The patients in the Ebstein group were followed up for an average of (64.44±34.85) months,and the patients in the control group were followed up for an average of (53.12± 13.83 ) months. No complications occurred in either group,neither group had recurring cases. Conclusion Radiofrequency catheter ablation for patients with Ebstein anomaly combined with pre-excitation syndrome can achieve the same clinical results compared with that for patients of pre-excitation syndrome with normal cardiac structure,but the operation time,ablation time,times of discharge,and discharge power are increased or prolonged.