[CARTO3系统下儿童室性早搏的射频导管消融：来自单一中心的回顾性研究]

[Radiofrequency catheter ablation of premature ventricular contractions in children under CARTO3 system: a retrospective study from one single center].

作者信息

Ji W, Wu J J, Qian Y J, Chen Y W, Fu L J, Shen J, Li F

机构信息

Department of Cardiology, Shanghai Children's Medical Centre, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.

出版信息

Zhonghua Er Ke Za Zhi. 2018 Jan 2;56(1):19-22. doi: 10.3760/cma.j.issn.0578-1310.2018.01.006.

DOI:10.3760/cma.j.issn.0578-1310.2018.01.006

PMID:29342992

Abstract

To evaluate the clinical effect and summarize the experience of radiofrequency catheter ablation (RFCA) for children suffered from premature ventricular contractions (PVCs). This retrospective study was conducted by descriptive analysis. A total of 108 cases with frequent PVCs from Shanghai Children's Medical Center were treated with RFCA under the guidance of CARTO3 system from January 2011 to December 2016. The immediate success rate of the procedure, the recurrence rate and the perioperative complications were summarized. The constituent ratio of different PVCs origins, the trend of overall procedure time and success rate in recent years were analyzed. Statistical analyses were performed using test. Immediate success of RFCA was achieved in 104 cases (96.3%, 104/108) and 4 cases (3.7%, 4/108) failed. The PVCs recurred during follow-up of over 6 months in 5 cases (4.8%, 5/104) . There were no severe complications related to the procedure. The sites of PVCs origin, in 52 cases originated from right ventricular outflow track (48.2%, 52/108) , 17 cases originated from left ventricular outflow track (15.7%, 17/108) and 26 cases originated from tricuspid annulus (24.1%, 26/108) . Among the three predilection sites of PVCs, the operation time was (141±46) min for right ventricular outflow track, (155±50) min for left ventricular outflow track, and (166±57) min for tricuspid annulus. However, the difference was not statistically significant (=1.79, =0.17) . X-ray exposure time was (14±8) minutes for right ventricular outflow track ablation, (32±14) minutes for left ventricular outflow track ablation and (16±8) minutes for tricuspid annulus ablation respectively. The exposure time for the ablation on left ventricle was significantly longer than the other two sites (=5.12, =0.018) . RFCA is safe and effective for PVCs in children with high success rate and low recurrence and complication rates.

摘要

评估射频导管消融术（RFCA）治疗儿童室性早搏（PVCs）的临床效果并总结经验。本回顾性研究采用描述性分析方法。2011年1月至2016年12月，上海儿童医学中心共108例频发室性早搏患儿在CARTO3系统引导下接受了射频导管消融术。总结手术即时成功率、复发率及围手术期并发症情况。分析不同室性早搏起源部位的构成比、近年来总体手术时间及成功率的变化趋势。采用检验进行统计学分析。104例（96.3%，104/108）射频导管消融术即时成功，4例（3.7%，4/108）失败。5例（4.8%，5/104）在随访6个月以上时室性早搏复发。无与手术相关的严重并发症。室性早搏起源部位中，52例起源于右心室流出道（48.2%，52/108），17例起源于左心室流出道（15.7%，17/108），26例起源于三尖瓣环（24.1%，26/108）。在室性早搏的三个好发部位中，右心室流出道手术时间为（141±46）分钟，左心室流出道为（155±50）分钟，三尖瓣环为（166±57）分钟。然而，差异无统计学意义（=1.79，=0.17）。右心室流出道消融的X线暴露时间为（14±8）分钟，左心室流出道消融的X线暴露时间为（32±14）分钟，三尖瓣环消融的X线暴露时间为（16±8）分钟。左心室消融的暴露时间明显长于其他两个部位（=5.12，=0.018）。射频导管消融术治疗儿童室性早搏安全有效，成功率高，复发率和并发症发生率低。