Topalović Mirko, Jan Matevž, Kalinšek Tine Prolič, Žižek David, Štublar Jernej, Rus Rina, Kuhelj Dimitrij
Cardiology Department, Pediatric Clinic, University Medical Centre Ljubljana, Bohoriceva 20, 1000 Ljubljana, Slovenia.
Cardiovascular Surgery Department, Surgical Clinic, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia.
Children (Basel). 2023 Sep 6;10(9):1513. doi: 10.3390/children10091513.
Catheter ablation (CA) of supraventricular tachycardias (SVTs) is conventionally performed with the aid of X-ray fluoroscopy. Usage of a three-dimensional (3D) electro-anatomical mapping (EAM) system and intracardiac echocardiography (ICE) enables zero-fluoroscopy ablation, eliminating the harmful effects of radiation. We retrospectively analyzed the feasibility, effectiveness and safety of zero-fluoroscopy radiofrequency and cryoablation of various types of SVTs in pediatric patients. Overall, in 171 consecutive patients (12.5 ± 3.9 years), 175 SVTs were diagnosed and 201 procedures were performed. The procedural success rate was 98% (193/197), or more precisely, 100% (86/86) for AVNRT, 95.8% (91/95) for AVRT, 94.1% (16/17) for AT and 100% (2/2) for AFL. No complications were recorded. Follow-up was complete in 100% (171/171) of patients. During the mean follow-up period of 488.4 ± 409.5 days, 98.2% of patients were arrhythmia-free with long-term success rates of 98.7% (78/79), 97.5% (78/80), 100% (13/13) and 100% (2/2) for AVNRT, AVRT, AT and AFL, respectively. Zero-fluoroscopy CA of various types of SVTs in the pediatric population is a feasible, effective and safe treatment option.
室上性心动过速（SVT）的导管消融术（CA）传统上是在X线透视辅助下进行的。使用三维（3D）电解剖标测（EAM）系统和心腔内超声心动图（ICE）可实现零透视消融，消除辐射的有害影响。我们回顾性分析了小儿患者各类SVT零透视射频和冷冻消融的可行性、有效性和安全性。总体而言，在171例连续患者（12.5±3.9岁）中，诊断出175例SVT，并进行了201次手术。手术成功率为98%（193/197），更确切地说，房室结折返性心动过速（AVNRT）为100%（86/86），房室折返性心动过速（AVRT）为95.8%（91/95），房性心动过速（AT）为94.1%（16/17），房扑（AFL）为100%（2/2）。未记录到并发症。100%（171/171）的患者完成了随访。在平均488.4±409.5天的随访期内，98.2%的患者无心律失常，AVNRT、AVRT、AT和AFL的长期成功率分别为98.7%（78/79）、97.5%（78/80）、100%（13/13）和100%（2/2）。小儿人群各类SVT的零透视CA是一种可行、有效且安全的治疗选择。
