Nielsen Jens Cosedis, Kottkamp Hans, Piorkowski Christopher, Gerds-Li Jin-Hong, Tanner Hildegard, Hindricks Gerhard
Herzzentrum Leipzig, University Hospital Leipzig, Leipzig, Germany.
Europace. 2006 May;8(5):323-9. doi: 10.1093/europace/eul021.
The experience of using radiofrequency ablation (RFA) for the treatment of arrhythmias in children and adolescents is still limited. This study aimed to review the most recent results of RF ablation in children and adolescents in a highly experienced centre with access to both conventional techniques and non-fluoroscopic electroanatomic mapping (CARTO).
A total of 154 consecutive patients younger than 19 years treated with RFA during the period 2000-04 were included. Numbers (%) or median (quartiles) are reported. Age was 15 (12-17) years, 70 (45%) were males. Five patients (3%) had congenital heart disease. RFA was successful in 147/154 patients (95%). Arrhythmia recurrence occurred in 11 patients (7%). Procedure time was 55 (35-90) min and fluoroscopy time was 8.8 (4-19) min. Number of RF applications was 4 (2-10) and number of RF applications >20 s was 2 (1-7). One patient (0.7%) had complicating high-grade atrioventricular block. CARTO was used in 18 RF ablation procedures (11%) performed in 15 patients.
RF ablation can be undertaken in children and adolescents with a high success rate, few recurrences and complications, very short procedure times, and acceptable fluoroscopy times. Non-fluoroscopic electroanatomic mapping is helpful in selected patients.
儿童和青少年心律失常采用射频消融(RFA)治疗的经验仍然有限。本研究旨在回顾一家经验丰富的中心采用常规技术和非荧光透视电解剖标测(CARTO)对儿童和青少年进行射频消融的最新结果。
纳入2000年至2004年期间接受RFA治疗的154例连续19岁以下患者。报告数字(%)或中位数(四分位数)。年龄为15(12 - 17)岁,70例(45%)为男性。5例(3%)患有先天性心脏病。147/154例患者(95%)射频消融成功。11例患者(7%)出现心律失常复发。手术时间为55(35 - 90)分钟,透视时间为8.8(4 - 19)分钟。射频应用次数为4(2 - 10)次,射频应用时间>20秒的次数为2(1 - 7)次。1例患者(0.7%)出现严重房室传导阻滞并发症。15例患者进行的18例(11%)射频消融手术中使用了CARTO。
儿童和青少年进行射频消融成功率高、复发率和并发症少、手术时间非常短且透视时间可接受。非荧光透视电解剖标测对部分患者有帮助。