Sreeram N, Emmel M, Trieschmann U, de Haan E
University Hospital of Cologne, Germany.
Indian Pacing Electrophysiol J. 2008 May 1;8(Suppl. 1):S36-54.
Catheter ablation of arrhythmias in children has become standard practice virtually worldwide. Successful and safe ablation has been made possible by a combination of factors. These include increased operator experience, a better understanding of the natural history of a wide variety of arrhythmias, advances in technology such as smaller catheters, the routine use of various three-dimensional mapping systems, and the development of alternative energy sources. It is also not uncommon to perform multiple catheter intervention procedures (ablation +/- intravascular stent implantation +/- device closure of residual shunts +/- elective pacemaker or device implantation) during a single session. It is important to bear in mind that arrhythmia recurrence is commoner in children in general, and that this is particularly the case with postoperative (scar-related arrhythmias). Despite acute success, long-term follow-up is mandated for this subgroup of patients.
儿童心律失常的导管消融术在全球范围内几乎已成为标准治疗方法。多种因素共同作用使得成功且安全的消融成为可能。这些因素包括术者经验的增加、对各种心律失常自然病程的更好理解、技术进步（如更小的导管）、各种三维标测系统的常规使用以及替代能源的发展。在单次手术中进行多种导管介入操作（消融+/-血管内支架植入+/-残余分流的装置封堵+/-择期起搏器或装置植入）也并不罕见。必须牢记，一般而言，心律失常复发在儿童中更为常见，术后（与瘢痕相关的心律失常）尤其如此。尽管急性期取得了成功，但该亚组患者仍需进行长期随访。
