Department of Cardiology, UMC St. Radboud, Pegasusplaats 202, 6525, JK, Nijmegen, the Netherlands,
Neth Heart J. 2013 Jun;21(6):296-303. doi: 10.1007/s12471-013-0408-9.
Although rare, children and young adults can suffer from significant cardiac arrhythmia, especially in the context of congenital malformations and after cardiac surgery.
A total of 62 patients (32 female, median age 20 years) underwent an invasive electrophysiology study between 2008-2011: half had normal cardiac anatomy, whereas the remaining patients had various types of congenital heart disease. All patients were treated using either conventional techniques (CVN) or remote magnetic navigation (RMN).
Patients treated with the RMN system differed substantially from patients in the CVN group with respect to presence of congenital heart disease (67 % vs. 37 %), previous cardiac surgery (59 % vs. 20 %) or failed previous conventional ablation (22 % vs. 9 %), respectively. Although these more complex arrhythmias resulted in longer median procedure duration (180 vs. 130 min, p = 0.034), the median overall fluoroscopy exposure in the RMN group was significantly lower (4.1 vs. 5.2 min, p = 0.020). Clinical outcome was comparable in both groups without complications caused by the ablation.
Catheter ablation using remote magnetic navigation is safe and feasible in children and young adults and is especially valuable in patients with abnormal cardiac morphologies. RMN resulted in significantly lower radiation exposure compared with the conventional technique.
尽管罕见，但儿童和青少年也可能发生严重的心律失常，尤其是在先天性畸形和心脏手术后。
共有 62 名患者（32 名女性，中位年龄 20 岁）于 2008 年至 2011 年间接受了介入性电生理研究：一半患者心脏解剖结构正常，而其余患者患有各种类型的先天性心脏病。所有患者均采用常规技术（CVN）或远程磁导航（RMN）进行治疗。
与 CVN 组相比，RMN 组的患者在先天性心脏病（67%比 37%）、既往心脏手术（59%比 20%）或既往常规消融失败（22%比 9%）的发生率方面存在显著差异。尽管这些更复杂的心律失常导致中位手术时间延长（180 分钟比 130 分钟，p=0.034），但 RMN 组的中位总透视时间明显更低（4.1 分钟比 5.2 分钟，p=0.020）。两组的临床结果相当，消融均无并发症。
远程磁导航引导下心导管消融术在儿童和青少年中是安全且可行的，对于心脏形态异常的患者尤其有价值。与传统技术相比，RMN 可显著降低辐射暴露。
