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婴幼儿及儿童持续性室上性心动过速射频消融术后左心室功能障碍的恢复模式

Recovery pattern of left ventricular dysfunction following radiofrequency ablation of incessant supraventricular tachycardia in infants and children.

作者信息

De Giovanni J V, Dindar A, Griffith M J, Edgar R A, Silove E D, Stumper O, Wright J G

机构信息

Heart Unit, Birmingham Children's Hospital NHS Trust, Ladywood Middleway, UK.

出版信息

Heart. 1998 Jun;79(6):588-92. doi: 10.1136/hrt.79.6.588.

Abstract

OBJECTIVE

To assess recovery pattern of left ventricular function secondary to incessant tachycardia after radiofrequency ablation in a group of infants and children.

DESIGN AND SETTING

A combined prospective and retrospective echocardiographic study carried out in a tertiary paediatric cardiac centre.

PATIENTS

Echocardiographic evaluation of left ventricular size and function in nine children with incessant tachycardia, before and after successful radiofrequency ablation. Age at ablation ranged from 2 months to 12.5 years (mean 4.1 years). Recovery of left ventricular function was analysed in relation to age at ablation (group I < 18 months, group II > 18 months).

MAIN OUTCOME MEASURE

Ventricular recovery pattern.

RESULTS

Seven of the nine children had left ventricular dysfunction; six of these also had left ventricular dilatation. All children with left ventricular dysfunction had normalisation of ejection fraction and fractional shortening; left ventricular dilatation also improved, but the improvement occurred after recovery of function. There was a shorter recovery time for left ventricular function in younger (group I) than in older children (group II) (mean (SD) 5.7 (7.2) months v 31.3 (5.2) (p < 0.002).

CONCLUSIONS

Tachycardia induced cardiomyopathy is reversible following curative treatment with radiofrequency. Recovery of left ventricular systolic function precedes recovery of left ventricular dilatation. Time course to recovery is shorter in younger children.

摘要

目的

评估一组婴幼儿和儿童射频消融术后持续性心动过速继发的左心室功能恢复模式。

设计与背景

在一家三级儿科心脏中心进行的一项前瞻性和回顾性超声心动图联合研究。

患者

对9例持续性心动过速患儿在成功进行射频消融术前、后的左心室大小和功能进行超声心动图评估。消融时年龄范围为2个月至12.5岁(平均4.1岁)。根据消融时的年龄(I组<18个月,II组>18个月)分析左心室功能的恢复情况。

主要观察指标

心室恢复模式。

结果

9例患儿中有7例存在左心室功能障碍;其中6例还伴有左心室扩张。所有左心室功能障碍患儿的射血分数和缩短分数均恢复正常;左心室扩张也有所改善,但功能恢复后才出现改善。年龄较小的患儿(I组)左心室功能恢复时间比年龄较大的患儿(II组)短(平均(标准差)5.7(7.2)个月对31.3(5.2)个月,p<0.002)。

结论

射频根治性治疗后,心动过速性心肌病是可逆的。左心室收缩功能的恢复先于左心室扩张的恢复。年龄较小的患儿恢复所需时间较短。

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本文引用的文献

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