Dalili Mohammad, Kargarfard Mohammadreza, Tabib Avisa, Fathollahi Mahmood Sheikh, Brugada Pedro
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Department of Pediatrics, Children's Hospital, School of Medicine, Hormozgan University of Medical Science, Bandar Abbas, Iran.
Indian Pacing Electrophysiol J. 2023 Jul-Aug;23(4):99-107. doi: 10.1016/j.ipej.2023.03.002. Epub 2023 Mar 9.
The ablation of ventricular tachycardia, including premature ventricular contractions, is an approved, albeit infrequent procedure in pediatric patients. Data are scarce regarding the outcomes of this procedure. The purpose of this study was to share a high-volume center experience and patient outcomes for catheter ablation of ventricular ectopy and ventricular tachycardia in pediatric population.
Data were retrieved from the institutional data bank. Outcomes over time were evaluated, and procedural details were compared.
A total of 116 procedures were performed on 102 pediatric patients between July 2009 and May 2021 at the Rajaie Cardiovascular Medical and Research Center in Tehran, Iran. Ablation was not performed in 4 procedures (3.4%) due to high-risk substrates. Of the remaining 112 ablations performed, 99 (88.4%) were successful. However, one patient died due to a coronary complication. There were no significant differences observed in early ablation results based on patients' age, sex, cardiac anatomy, or ablation substrates (P > 0.05). Follow-up records were available for 80 procedures, and 13 (16.3%) of those experienced recurrence. During long-term follow-up, none of the variables mentioned above were statistically different between patients with or without arrhythmia recurrence.
The overall success rate of pediatric ventricular arrhythmia ablation is favorable. We found no significant predictor for the procedural success rate concerning acute and late outcomes. Larger multicenter studies are needed to elucidate the predictors and outcomes of the procedure.
室性心动过速(包括室性早搏)的消融术在儿科患者中是一种已获批准的治疗方法,尽管并不常用。关于该手术效果的数据较为匮乏。本研究的目的是分享一家高容量中心在儿科人群中进行室性早搏和室性心动过速导管消融的经验及患者预后情况。
数据从机构数据库中获取。评估随时间变化的预后情况,并比较手术细节。
2009年7月至2021年5月期间,伊朗德黑兰拉贾伊心血管医学与研究中心对102例儿科患者共进行了116例手术。由于存在高风险基质,4例手术(3.4%)未进行消融。在其余112例已进行的消融手术中,99例(88.4%)成功。然而,有1例患者因冠状动脉并发症死亡。基于患者年龄、性别、心脏解剖结构或消融基质,早期消融结果未观察到显著差异(P>0.05)。有80例手术的随访记录,其中13例(16.3%)出现复发。在长期随访中,上述变量在有或无心律失常复发的患者之间均无统计学差异。
儿科室性心律失常消融术的总体成功率良好。我们未发现与急性和晚期预后相关的手术成功率的显著预测因素。需要开展更大规模的多中心研究来阐明该手术的预测因素和预后情况。