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0至4岁和5至9岁儿童室上性心动过速的射频导管消融:一项对比研究

Radiofrequency catheter ablation for supraventricular tachycardia: a comparison study of children aged 0-4 and 5-9 years.

作者信息

An Hyo Soon, Choi Eun Young, Kwon Bo Sang, Kim Gi Beom, Bae Eun Jung, Noh Chung Il, Choi Jung Yun

机构信息

Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea.

出版信息

Pacing Clin Electrophysiol. 2013 Dec;36(12):1488-94. doi: 10.1111/pace.12267. Epub 2013 Sep 13.

Abstract

BACKGROUND

The safety and effectiveness of radiofrequency catheter ablation (RFCA) for supraventricular tachycardia (SVT) in young children was investigated.

METHODS

Ninety-five children who underwent RFCA procedures were stratified according to age (group 1, 0-4 years, n = 24; group 2, 5-9 years, n = 71) and were evaluated retrospectively.

RESULTS

Among the 95 patients, atrioventricular reentrant tachycardia was 78.9%, atrioventricular nodal reentrant tachycardia was 10.5%, and ectopic atrial tachycardia was 8.4%. The acute success rate of RFCA was 97.9% and the recurrence rate was 11.6%. RFCA was performed for different main reasons in each group, including drug-resistant tachycardia (37.5% in group 1 vs 7% in group 2; P = 0.001) and symptomatic tachycardia (4.2% in group 1 vs 57.7% in group 2; P < 0.001). There was no significant difference in success rate, recurrence rate, and procedure and fluoroscopy duration between the two groups. The acute success rates did not differ significantly between patients with a single accessory pathway (AP) and those with multiple APs; however, failure or recurrence was more common in the patients with multiple APs (38.5% vs 11.5%; P = 0.01). The multiple APs were found frequently on the right side (P = 0.005). Septal dyskinesia with left ventricular dysfunction in Wolff-Parkinson-White syndrome and tachycardia-induced cardiomyopathy improved after RFCA.

CONCLUSIONS

RFCA was found to be effective and safe for SVT in young children.

摘要

背景

研究了射频导管消融术(RFCA)治疗小儿室上性心动过速(SVT)的安全性和有效性。

方法

95例行RFCA手术的儿童按年龄分层(第1组,0 - 4岁,n = 24;第2组,5 - 9岁,n = 71),并进行回顾性评估。

结果

95例患者中,房室折返性心动过速占78.9%,房室结折返性心动过速占10.5%,房性异位性心动过速占8.4%。RFCA的急性成功率为97.9%,复发率为11.6%。每组进行RFCA的主要原因不同,包括药物难治性心动过速(第1组为37.5%,第2组为7%;P = 0.001)和有症状的心动过速(第1组为4.2%,第2组为57.7%;P < 0.001)。两组在成功率、复发率以及手术和透视时间方面无显著差异。单条旁路(AP)患者和多条AP患者的急性成功率无显著差异;然而,多条AP患者失败或复发更为常见(38.5%对11.5%;P = 0.01)。多条AP多见于右侧(P = 0.005)。 Wolff - Parkinson - White综合征合并左心室功能不全的室间隔运动障碍和心动过速性心肌病在RFCA后有所改善。

结论

RFCA治疗小儿SVT有效且安全。

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