预激综合征导管消融术的成功率和安全性：成人与儿童患者的比较。
Success rate and safety of catheter ablation in preexcitation syndrome: A comparison between adult and pediatric patients.
机构信息
Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Poland.
Student Scientific Circle, Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Poland.
出版信息
Cardiol J. 2022;29(1):88-92. doi: 10.5603/CJ.a2020.0030. Epub 2020 Mar 24.
BACKGROUND
In contrast to adults, in whom cardiac rhythm disorders are mainly conditioned by coronary artery disease, in children, arrhythmias are most often associated with inherited heart disorders. Catheter ablation (CA) has an important role in the management of cardiac arrhythmias, in adults and children. The aim of the study was to assess and compare the efficacy and safety of CA in children and adults with preexcitation syndrome.
METHODS
The study population comprised 43 adults and 43 children diagnosed with a Wolff-Parkinson-White syndrome (WPW). The mean age of the study population was 41 ± 15 years for adults and 14 ± 2.5 years for children. In all patients, an electrophysiological study and CA were performed. Analysis with respect to the procedure duration, fluoroscopy exposure time, location of accessory pathways (AP), immediate success rate and complications were performed.
RESULTS
Electrophysiological study revealed the most frequent presence of left-sided AP (56% in children and 70% in adults). The mean procedure duration was 96 ± 36 min and 106 ± 51 min in children and adults, respectively (p = NS). The mean fluoroscopy duration was 8.5 ± 4.3 min and 5.9 ± 5.8 min in children and adults, respectively p < 0.05. The CA procedure was successful in 40 out of 43 (93%) adults and in 36 out of 43 (83.7%) children (p = NS). In 2 (4%) children minor complications occurred.
CONCLUSIONS
Ablation in children and adults are equally effective with respect to short-term clinical observation.
背景
与成年人不同，成年人的心律失常主要由冠状动脉疾病引起，而在儿童中，心律失常最常与遗传性心脏病有关。导管消融（CA）在成人和儿童心律失常的治疗中具有重要作用。本研究的目的是评估和比较预激综合征患儿和成人 CA 的疗效和安全性。
方法
研究人群包括 43 名成人和 43 名被诊断为 Wolff-Parkinson-White 综合征（WPW）的儿童。研究人群的平均年龄为 41 ± 15 岁（成人）和 14 ± 2.5 岁（儿童）。所有患者均进行电生理研究和 CA。对手术持续时间、透视曝光时间、旁路（AP）的位置、即刻成功率和并发症进行分析。
结果
电生理研究显示最常见的左侧 AP（儿童 56%，成人 70%）。儿童和成人的平均手术持续时间分别为 96 ± 36 分钟和 106 ± 51 分钟（p = NS）。儿童和成人的平均透视时间分别为 8.5 ± 4.3 分钟和 5.9 ± 5.8 分钟（p < 0.05）。43 例成人中有 40 例（93%）和 43 例儿童中有 36 例（83.7%）CA 手术成功（p = NS）。2 例（4%）儿童出现轻微并发症。
结论
在短期临床观察方面，儿童和成人的消融效果相同。
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