Silver Eric S, Silva Jennifer N A, Ceresnak Scott R, Chiesa Nancy A, Rhee Edward K, Dubin Anne M, Avasarala Kishor, Van Hare George F, Collins Kathryn K
Division of Pediatric Cardiology, Morgan Stanley Children's Hospital of New York Presbyterian Hospital, Columbia University, New York, New York 10032, USA.
Pacing Clin Electrophysiol. 2010 Jun 1;33(6):681-6. doi: 10.1111/j.1540-8159.2010.02706.x. Epub 2010 Mar 5.
Cryoablation with 4- and 6-mm tip ablation catheters has been demonstrated to be safe and effective in the treatment of atrioventricular nodal reentrant tachycardia (AVNRT) in pediatric patients, albeit with a higher rate of clinical recurrence. Limited information is available regarding efficacy, mid-term outcomes, and complications related to the use of the 8-mm Freezor Max Cryoablation catheter (Medtronic, Minneapolis, MN, USA) in pediatric patients.
We performed a retrospective review of all pediatric patients with normal cardiac anatomy who underwent an ablation procedure for treatment of AVNRT using the 8-mm tip Cryoablation catheter at three large pediatric academic arrhythmia centers.
Cryoablation with an 8-mm tip catheter was performed in 77 patients for treatment of AVNRT (female n = 40 [52%], age 14.8 +/- 2.2 years, weight 62.0 +/- 13.9 kg). Initial procedural success was achieved in 69 patients (69/76, 91%). Transient second- or third-degree atrioventricular (AV) block was noted in five patients (6.5%). There was no permanent AV block. Of the patients successfully ablated with Cryotherapy, there were two recurrences (2/70, 2.8%) over a follow-up of 11.6 +/- 3.3 months.
Cryoablation with an 8-mm tip ablation catheter is both safe and effective with a low risk of recurrence for the treatment of AVNRT in pediatric patients.
尽管临床复发率较高,但已证明使用4毫米和6毫米尖端消融导管进行冷冻消融治疗小儿房室结折返性心动过速(AVNRT)是安全有效的。关于使用8毫米Freezor Max冷冻消融导管(美敦力公司,美国明尼阿波利斯)治疗小儿患者的疗效、中期结果和并发症的信息有限。
我们对三个大型小儿学术性心律失常中心所有心脏解剖结构正常、使用8毫米尖端冷冻消融导管进行AVNRT消融治疗的小儿患者进行了回顾性研究。
77例患者使用8毫米尖端导管进行冷冻消融治疗AVNRT(女性40例[52%],年龄14.8±2.2岁,体重62.0±13.9千克)。69例患者(69/76,91%)获得了初始手术成功。5例患者(6.5%)出现短暂性二度或三度房室(AV)阻滞。无永久性AV阻滞。在接受冷冻消融成功治疗的患者中,随访11.6±3.3个月期间有2例复发(2/70,2.8%)。
使用8毫米尖端消融导管进行冷冻消融治疗小儿AVNRT安全有效,复发风险低。