Ozyilmaz Isa, Ergul Yakup, Akdeniz Celal, Ozturk Erkut, Tanidir Ibrahim C, Tuzcu Volkan
Department of Pediatric Cardiology,Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital,Istanbul,Turkey.
Cardiol Young. 2014 Oct;24(5):886-92. doi: 10.1017/S1047951113001364. Epub 2013 Sep 10.
Curative therapy of idiopathic ventricular tachycardia remains a challenge in interventional electrophysiology. The aim of this study was to demonstrate the utility of an EnSite NavX system in the catheter ablation of idiopathic ventricular tachycardia in children.
In all, 17 children with idiopathic ventricular tachycardia underwent electrophysiological studies using the EnSite NavX system guidance.
The mean patient age was 13 ± 2.4 years (range: 7.8-17.9) and the mean patient weight was 52.3 ± 11.9 kg (range: 32-75). The origin of ventricular tachycardia was in the right ventricular outflow tract in nine patients, in the left ventricle in six, near the bundle of His/right bundle branch in one, and in the left aortic cusp in one. The mean procedure and fluoroscopy times were 169.3 ± 43.2 minutes and 8 ± 10.8 minutes, respectively. No fluoroscopy was used in six patients. The mean radiation exposure was 33.1 ± 56.4 mGy. Acute success was achieved in 14 patients (82%). The focus of ventricular tachycardia was epicardial in two failed procedures. During a mean follow-up of 8.5 ± 7.6 months, ventricular tachycardia recurred in three patients, two of whom underwent a second procedure. Except for one patient who developed transient right bundle branch block, no complications were seen.
Catheter ablation of idiopathic ventricular tachycardia in children can be performed safely and effectively with low fluoroscopy exposure using the EnSite NavX system.
特发性室性心动过速的根治性治疗在介入电生理学中仍然是一项挑战。本研究的目的是证明EnSite NavX系统在儿童特发性室性心动过速导管消融中的实用性。
共有17例特发性室性心动过速患儿在EnSite NavX系统引导下进行了电生理研究。
患者平均年龄为13±2.4岁（范围：7.8 - 17.9岁），平均体重为52.3±11.9 kg（范围：32 - 75 kg）。室性心动过速的起源在右心室流出道9例，左心室6例，希氏束/右束支附近1例，左主动脉瓣窦1例。平均手术时间和透视时间分别为169.3±43.2分钟和8±10.8分钟。6例患者未使用透视。平均辐射暴露量为33.1±56.4 mGy。14例患者（82%）取得急性成功。2例手术失败患者的室性心动过速起源于心肌外膜。在平均8.5±7.6个月的随访期间，3例患者室性心动过速复发，其中2例接受了二次手术。除1例患者出现短暂性右束支传导阻滞外，未见并发症。
使用EnSite NavX系统，儿童特发性室性心动过速的导管消融可以在低透视暴露下安全有效地进行。
