Von Bergen Nicholas H, Bansal Shalabh, Gingerich Jean, Law Ian H
The University of Iowa Children's Hospital, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52246, USA.
Pediatr Cardiol. 2011 Aug;32(6):743-7. doi: 10.1007/s00246-011-9956-1. Epub 2011 Mar 27.
The purpose of this study was to report the feasibility and procedural technique of minimal or no fluoroscopy in the ablation of ventricular arrhythmias in the pediatric population. A retrospective review was performed of all patients <21 years old who underwent ablation of ventricular arrhythmias using three-dimensional (3D) mapping with no or minimal fluoroscopy at a single institution. Five patients underwent electrophysiology studies for ventricular tachycardia or frequent premature ventricular complexes. Three patients had right-sided arrhythmias, and two patients had left-sided arrhythmias. Electro-anatomic mapping with the 3D EnSite NavX system and radiofrequency ablation was used in all patients. No fluoroscopy was used in the patients with right-sided arrhythmias. The two patients with left-sided arrhythmias had 1.0 and 1.9 min of fluoroscopy, respectively. The mean procedure time was 168 min (range 95 to 270). There has been no recurrence at mean follow-up of >1 year. Three-dimensional mapping systems have allowed pediatric electrophysiologic procedures to be performed with minimal to no fluoroscopy in patients with challenging arrhythmias, including ventricular arrhythmias. The decrease in radiation exposure decreases the risk of long-term adverse sequelae resulting from radiation exposure, which is especially important in children.
本研究的目的是报告在儿科人群中进行室性心律失常消融时使用最少或不使用荧光透视检查的可行性及操作技术。对在单一机构接受使用三维（3D）标测且无荧光透视或荧光透视最少的室性心律失常消融的所有21岁以下患者进行了回顾性研究。5例患者因室性心动过速或频发室性早搏接受了电生理检查。3例患者为右侧心律失常，2例患者为左侧心律失常。所有患者均使用3D EnSite NavX系统进行电解剖标测及射频消融。右侧心律失常患者未使用荧光透视检查。2例左侧心律失常患者的荧光透视时间分别为1.0分钟和1.9分钟。平均手术时间为168分钟（范围95至270分钟）。平均随访>1年无复发。三维标测系统使儿科电生理手术能够在包括室性心律失常在内的具有挑战性的心律失常患者中以最少或不使用荧光透视的方式进行。辐射暴露的减少降低了因辐射暴露导致的长期不良后遗症的风险，这在儿童中尤为重要。
