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6毫米与8毫米尖端冷冻消融导管治疗儿童房室结折返性心动过速的比较:一项前瞻性研究

Comparison of 6-mm Versus 8-mm-Tip Cryoablation Catheter for the Treatment of Atrioventricular Nodal Reentrant Tachycardia in Children: A Prospective Study.

作者信息

Tuzcu Volkan, Gul Enes Elvin, Karacan Mehmet, Kamali Hacer, Celik Nida, Akdeniz Celal

机构信息

Pediatric and Genetic Arrhythmia Center, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe Cikisi, No 1, Bagcilar, 14, Istanbul, Turkey.

出版信息

Pediatr Cardiol. 2017 Aug;38(6):1220-1225. doi: 10.1007/s00246-017-1648-z. Epub 2017 Jun 13.

Abstract

Due to its safety profile, cryoablation (Cryo) for atrioventricular nodal reentrant tachycardia (AVNRT) is more commonly preferred over radiofrequency (RF) ablation in children in recent years. Recent studies demonstrated high long-term success rates comparable to radiofrequency ablation. The aim of this prospective study was to compare the efficacy and safety of an 8-mm-tip versus 6-mm-tip Cryo catheter in the treatment of AVNRT in children. A total of 125 consecutive patients over 10 years of age with AVNRT were included. EnSite system (St. JudeMedical, St Paul, MN, USA) was used to reduce or eliminate fluoroscopy. The acute procedural success was 100% in both groups. The prodecure duration for the 8-mm-tip group was shorter (151.6 ± 63.2 vs. 126.6 ± 36.7 min, p < 0.01, respectively). Fluoroscopy was used in only 7 patients. The mean follow-up duration was 14.6 ± 8.4 months (median 13.5 months, min. 3 months and max. 27 months). The recurrence rate for AVNRT was also comparable between the two groups (6-mm tip: 9.6 vs. 8-mm tip: 8%). Cryo of AVNRT is a safe and effective procedure with comparable acute and mid-term follow-up success rates using 6-mm and 8-mm-tip catheters in children. In addition, procedure duration is shorter with an 8-mm-tip Cryo catheter.

摘要

由于其安全性,近年来在儿童房室结折返性心动过速(AVNRT)的治疗中,冷冻消融(Cryo)比射频(RF)消融更受青睐。近期研究表明,其长期成功率较高,与射频消融相当。这项前瞻性研究的目的是比较8毫米尖端与6毫米尖端冷冻导管治疗儿童AVNRT的疗效和安全性。总共纳入了125例年龄超过10岁的连续性AVNRT患者。使用EnSite系统(美国明尼苏达州圣保罗市圣犹达医疗公司)以减少或消除荧光透视。两组的急性手术成功率均为100%。8毫米尖端组的手术时间较短(分别为151.6±63.2分钟和126.6±36.7分钟,p<0.01)。仅7例患者使用了荧光透视。平均随访时间为14.6±8.4个月(中位数13.5个月,最短3个月,最长27个月)。两组间AVNRT的复发率也相当(6毫米尖端组:9.6% vs 8毫米尖端组:8%)。在儿童中,使用6毫米和8毫米尖端导管进行AVNRT的冷冻消融是一种安全有效的手术,急性和中期随访成功率相当。此外,8毫米尖端冷冻导管的手术时间更短。

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