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射频导管消融治疗儿童阵发性室上性心动过速:来自中低收入国家的安全性和疗效的见解。

Radiofrequency catheter ablation for paroxysmal supraventricular tachycardia in children: Insights on its safety and efficacy from a lower middle-income country.

机构信息

Department of Cardiology, University Medical Center HCMC, Ho Chi Minh City, Vietnam.

Department of Cardiology, Children's Hospital 1, Ho Chi Minh City, Vietnam.

出版信息

Int J Med Sci. 2023 Aug 15;20(10):1293-1299. doi: 10.7150/ijms.86594. eCollection 2023.

Abstract

Radiofrequency catheter ablation (RFCA) is a safe and effective treatment for paroxysmal supraventricular tachycardia in adults. However, data on its use in children, particularly from low- and middle-income countries, are limited. This study aimed to evaluate the safety and efficacy of RFCA in children with paroxysmal supraventricular tachycardia from Vietnam. A prospective study was conducted from January 2009 to July 2016 at the University Medical Center, Ho Chi Minh City, Vietnam. Ninety-five children diagnosed with paroxysmal supraventricular tachycardia were enrolled; 90 patients underwent cardiac electrophysiology and RFCA. The patients were followed up for 3-12 months, with a mean follow-up period of 7.5 ± 2.3 months. The average age of the patients was 10.5 ± 3 years, with the youngest patient being 4 years old; 46.3% of the patients were female and 53.7% were male. The patients' average weight was 35.2 ± 9.6 kg. Atrioventricular reentrant tachycardia accounted for 72.6% of the cases and atrioventricular nodal reentrant tachycardia for 27.4% of the cases; no patients had atrial tachycardia. The success rate of RFCA was 98.9% (89/90 patients). During the 12-month follow-up, 5.6% of the patients experienced recurrence but were successfully treated with a second ablation. No severe complications were reported during the procedure and follow-up. This study found RFCA to be a safe and effective treatment for paroxysmal supraventricular tachycardia in children. It demonstrated a high success rate and low recurrence and complication rates for RFCA in children, thereby highlighting the potential advantages of the procedure as a treatment option.

摘要

射频导管消融术(RFCA)是治疗成人阵发性室上性心动过速的一种安全有效的方法。然而,关于其在儿童中的应用的数据,特别是来自低收入和中等收入国家的数据有限。本研究旨在评估 RFCA 在越南患有阵发性室上性心动过速的儿童中的安全性和疗效。

这是一项前瞻性研究,于 2009 年 1 月至 2016 年 7 月在越南胡志明市医疗中心进行。共有 95 例被诊断为阵发性室上性心动过速的儿童入选;90 例患者接受了心脏电生理和 RFCA 治疗。患者接受了 3-12 个月的随访,平均随访时间为 7.5±2.3 个月。

患者的平均年龄为 10.5±3 岁,最小的患者为 4 岁;46.3%的患者为女性,53.7%为男性。患者的平均体重为 35.2±9.6kg。房室折返性心动过速占 72.6%,房室结折返性心动过速占 27.4%;无患者发生房性心动过速。RFCA 的成功率为 98.9%(89/90 例)。在 12 个月的随访中,5.6%的患者复发,但经第二次消融治疗成功。在手术和随访过程中,无严重并发症发生。

本研究发现 RFCA 是治疗儿童阵发性室上性心动过速的一种安全有效的方法。它显示了 RFCA 在儿童中成功率高、复发率和并发症率低的特点,突出了该方法作为一种治疗选择的潜在优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a23e/10542029/4df9584ba4fc/ijmsv20p1293g001.jpg

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