Sileikiene Rima, Vaskelyte Jolanta, Mizariene Vaida, Nedzelskiene Irena, Verseckaite Raimonda, Jurkevicius Renaldas, Baksiene Dalia, Sileikyte Viktorija, Kevalas Rimantas
Department of Children Diseases, Lithuanian University of Health Sciences, Eiveniu 2, Kaunas, LT, 50009, Lithuania.
Pediatr Cardiol. 2011 Aug;32(6):792-800. doi: 10.1007/s00246-011-9983-y. Epub 2011 Apr 11.
This study was designed to assess the changes in the conductive system, autonomic dysfunction, and global and regional function of the atria and ventricles in children late after slow-pathway radiofrequency ablation (RFA). The study enrolled 22 children, who has successfully undergone RFA 2 to 5 years previously (RFA group) and 20 healthy children (control group). Electrophysiologic study was performed for the RFA group. Holter monitoring and echocardiography were performed for all the children. At a late follow-up assessment, the RFA children were free of paroxysms, whereas 8 of the 22 children (36%) reported transient palpitations. Both mean and maximal heart rates (HR) were significantly increased, whereas indices of HR variability (% of successive normal sinus RR intervals exceeding 50 ms [pNN50], root mean square of the successive normal sinus RR interval difference [rMSSD], high-frequency component [HFC]) were significantly decreased in the RFA group compared with preablation and control data. Left atrial (LA) and right atrial (RA) volumes were significantly higher, and atria deformation indices were significantly lower in the RFA group. Correlations were found between the mean HR and the volumes of LA (r = 0.477; p < 0.001) and RA (r = 0.512; p < 0.001). A negative correlation between the maximal LA volume and the longitudinal strain rate (SR) during relaxation (r = -0.476; p = 0.03) and a positive correlation between the minimal LA volume and both longitudinal SR (r = 0.361; p = 0.03) and strain (ε) (r = 0.375; p = 0.024) during contraction were shown. These data suggest a possible link between atrial dysfunction and the hyperadrenergic state after RFA.
本研究旨在评估儿童慢径射频消融术（RFA）后晚期传导系统、自主神经功能障碍以及心房和心室的整体及局部功能变化。该研究纳入了22名儿童，他们在2至5年前成功接受了RFA（RFA组）以及20名健康儿童（对照组）。对RFA组进行了电生理研究。对所有儿童进行了动态心电图监测和超声心动图检查。在晚期随访评估中，接受RFA的儿童未出现阵发性发作，而22名儿童中有8名（36%）报告有短暂心悸。与消融前及对照组数据相比，RFA组的平均心率和最大心率均显著增加，而心率变异性指标（连续正常窦性RR间期超过50 ms的百分比[pNN50]、连续正常窦性RR间期差值的均方根[rMSSD]、高频成分[HFC]）显著降低。RFA组的左心房（LA）和右心房（RA）容积显著更高，心房变形指数显著更低。发现平均心率与LA容积（r = 0.477；p < 0.001）和RA容积（r = 0.512；p < 0.001）之间存在相关性。舒张期最大LA容积与纵向应变率（SR）之间呈负相关（r = -0.476；p = 0.03），收缩期最小LA容积与纵向SR（r = 0.361；p = 0.03）和应变（ε）（r = 0.375；p = 0.024）之间呈正相关。这些数据表明RFA后心房功能障碍与高肾上腺素能状态之间可能存在联系。
