Department of Paediatrics, Yangzhou First People's Hospital, Yangzhou, China.
Department of Paediatrics, Renmin Hospital of Wuhan University, Wuhan, China.
Heart Surg Forum. 2020 Mar 11;23(2):E114-E117. doi: 10.1532/hsf.2837.
We aimed to evaluate the acute and long-term efficacy and safety of radiofrequency catheter ablation (RFCA) in Chinese pediatric patients with arrhythmias.
We gathered clinical data from pediatric patients who underwent RFCA in several large medical centers in China between 2000 and 2019.
A total of 4,622 different substrates in 4,622 patients were ablated, with the majority consisting of supraventricular tachycardia (N = 3,831, 82.9%) and ventricular arrhythmias (VAs) (N = 791, 17.1%). The majority of supraventricular tachycardia (SVT) consists of atrioventricular reentry tachycardia (AVRT) (N = 2,492, 65.0%) and atrioventricular nodal reentry tachycardia (AVNRT) (N = 1,075, 28.1%). The accessory pathway location was left-sided in 1,237(49.7%) and right-sided in 1,251(50.3%) of the 2,488 pathways. The VAs consist of premature ventricular contraction (PVC) (N = 597, 75.5%) and ventricular tachycardia (VT) (N = 194, 24.5%). The duration of follow-up ranged from 1 month to 1 year. The overall acute/long-term success rate of RFCA was 96.4%/92.2%, AVRT 97.8%/93.5%, AVRT 99.3%/95.0, PVC 98.1%/92.2%, and VT 81.3%/75.2%. Serious complications occurred in 29 patients (0.6%).
This present study shows that RFCA is effective and safe in the treatment of arrhythmias in Chinese pediatric patients, with a high success rate exceeding 90%, low recurrence rate, and significantly reduces the risk of complications. The success rate of left-sided pathway ablation is slightly higher than that of the right-sided pathway. There is no difference in the success rate of RFCA among children of different ages. It could be the first-line therapy in the majority of pediatric patients with SVT and/or VAs.
我们旨在评估射频导管消融（RFCA）在中国儿科心律失常患者中的急性和长期疗效和安全性。
我们收集了 2000 年至 2019 年间在中国几家大型医疗中心接受 RFCA 的儿科患者的临床数据。
共对 4622 例患者的 4622 种不同的基质进行了消融，其中大多数为室上性心动过速（SVT）（N = 3831，82.9%）和室性心律失常（VA）（N = 791，17.1%）。SVT 中大多数为房室折返性心动过速（AVRT）（N = 2492，65.0%）和房室结折返性心动过速（AVNRT）（N = 1075，28.1%）。2488 条旁道中，左侧 1237 条（49.7%），右侧 1251 条（50.3%）。VA 由频发室性期前收缩（PVC）（N = 597，75.5%）和室性心动过速（VT）（N = 194，24.5%）组成。随访时间从 1 个月到 1 年不等。RFCA 的总体急性/长期成功率为 96.4%/92.2%，AVRT 为 97.8%/93.5%，AVRT 为 99.3%/95.0%，PVC 为 98.1%/92.2%，VT 为 81.3%/75.2%。29 例患者发生严重并发症（0.6%）。
本研究表明，RFCA 治疗中国儿科心律失常患者有效且安全，成功率超过 90%，复发率低，显著降低并发症风险。左侧旁路消融的成功率略高于右侧旁路。不同年龄组儿童 RFCA 的成功率无差异。它可能是大多数 SVT 和/或 VA 儿科患者的一线治疗方法。
