Mosaed Pasha, Dalili Mohammad, Emkanjoo Zahra
Department of Pediatrics, Zanjan University of Medical Sciences, Zanjan, Iran.
Iran J Pediatr. 2012 Sep;22(3):333-8.
Ablation techniques of cardiac arrhythmia in children have significantly progressed in the past decade; however, the number of pediatric ablations is still significantly lower than that in adults. Accordingly, there is less information regarding the success rate and complications in this age group.
All pediatric ablations conducted between March 2005 and February 2011 at Rajaie Heart Center were studied. Abolishing the arrhythmia source by the end of procedure was considered as success. Recurrences before hospital discharge and those thereafter were named early recurrence and late recurrence, respectively.
A total of 125 catheter ablations were performed for 112 patients. Of them 118 (94.4%) procedures were successful. The success rate was significantly higher in the patients with atrioventricular nodal reentry tachycardia (AVNRT). Of 105 patients who continued follow-up program, 7 (6.7%) cases experienced recurrence; the recurrence rate was inversely dependent on the patients' body size (P-value <0.05). There was no mortality. Five cases were complicated during or early after the procedure, all the complications were cured completely.
Therapeutic electrophysiology in children is an effective and relatively low-risk method. The recurrence and complication rates are similar to those reported in adults. Considering our results and the previous reports, pediatric patients with serious arrhythmia should not be deprived from ablation and should not be exposed to long-term toxic drugs.
在过去十年中,儿童心律失常的消融技术有了显著进展;然而,儿科消融手术的数量仍明显低于成人。因此,关于这个年龄组的成功率和并发症的信息较少。
对2005年3月至2011年2月在拉贾伊心脏中心进行的所有儿科消融手术进行研究。手术结束时消除心律失常源被视为成功。出院前和出院后的复发分别称为早期复发和晚期复发。
共对112例患者进行了125次导管消融。其中118例(94.4%)手术成功。房室结折返性心动过速(AVNRT)患者的成功率明显更高。在105例继续随访的患者中,7例(6.7%)出现复发;复发率与患者体型呈负相关(P值<0.05)。无死亡病例。5例在手术期间或术后早期出现并发症,所有并发症均完全治愈。
儿童治疗性电生理学是一种有效且风险相对较低的方法。复发率和并发症发生率与成人报告的相似。考虑到我们的结果和先前的报告,患有严重心律失常的儿科患者不应被剥夺消融治疗的机会,也不应长期使用有毒药物。