Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
Hong Kong Med J. 2012 Jun;18(3):207-13.
To compare the outcome of cryothermal and radiofrequency energy transcatheter ablation of atrioventricular junctional re-entrant tachycardia in children and adolescents.
Case series with internal comparison.
Two hospitals in Hong Kong.
Consecutive transcatheter ablation procedures for atrioventricular junctional re-entrant tachycardia in children and adolescents in our unit from August 2000 to September 2008 were retrospectively reviewed. Radiofrequency ablation was performed from August 2000 to June 2005, and cryoablation from July 2005 to September 2008.
Demographic data, outcome and procedural details.
Thirty-eight procedures were reviewed. The radiofrequency ablation group (n=20) and cryoablation group (n=18) had similar demographic characteristics, except that there were more patients with congenital heart disease in the latter group (P=0.03). Acute procedural success rate was 100% in both groups. One patient from the radiofrequency ablation group had recurrence of atrioventricular junctional re-entrant tachycardia. The frequency of post-ablation persistent heart block was higher in the radiofrequency ablation than cryoablation group (10% vs 0%, P=0.17), but this difference was not statistically significant. A shorter fluoroscopy time was noted in the cryoablation group (31 ± 13 vs 38 ± 18 minutes; P=0.03).
Transcatheter cryoablation for atrioventricular junctional re-entrant tachycardia in children and adolescents is as effective as radiofrequency ablation over the medium term. It has an excellent safety profile in terms of avoiding heart block.
比较儿童和青少年房室结折返性心动过速经冷冻和射频消融的疗效。
病例系列并作内部比较。
两所香港医院。
2000 年 8 月至 2008 年 9 月，我们科室连续进行了儿童和青少年房室结折返性心动过速的经导管消融术，对这些病例进行回顾性分析。射频消融术在 2000 年 8 月至 2005 年 6 月进行，冷冻消融术在 2005 年 7 月至 2008 年 9 月进行。
人口统计学资料、结果和手术细节。
38 例手术入选。射频消融组（n=20）和冷冻消融组（n=18）除后者先天性心脏病患者较多（P=0.03）外，其他特征相似。两组即刻手术成功率均为 100%。射频消融组有 1 例患者出现房室结折返性心动过速复发。射频消融组较冷冻消融组术后持续性完全性房室传导阻滞发生率高（10%比 0%，P=0.17），但差异无统计学意义。冷冻消融组透视时间较短（31±13 比 38±18 分钟，P=0.03）。
儿童和青少年房室结折返性心动过速的经导管冷冻消融与射频消融比较，中期疗效相当，避免完全性房室传导阻滞方面有较好的安全性。
