Division of Pediatric Cardiology, University of Minnesota, Minneapolis, Minnesota, USA.
Division of Pediatric Cardiology, UC Davis Medical System, Sacramento, California, USA.
Pacing Clin Electrophysiol. 2023 Nov;46(11):1310-1314. doi: 10.1111/pace.14833. Epub 2023 Oct 4.
Atrioventricular nodal reentrant tachycardia (AVNRT) does not commonly present during infancy. Although relative safety of catheter ablation of AVNRT has been demonstrated in pediatrics, this procedure is rarely indicated in children <15 kg.
Retrospective review of seven cases of AVNRT that presented in children younger than 1 year of age and required catheter ablation for definitive management. Electrophysiology (EP) study was planned with two or three catheters. Area of ablation determined by voltage mapping, propagation sinus wave collision and slow pathway potential location. Ablation performed with cryothermal energy. No fluoroscopy was used.
Presentation ranged from 36 weeks of gestation to 11 months of age. Two presented in fetal life and two in the neonatal period. The median age of ablation was 20 months (range 17-31 months). The median weight at ablation was 11.4 kg (range 8.9-14.9 kg). Median follow-up time was 16 months. All had typical AVNRT. The median tachycardia cycle length was 216 ms. 100% successful rate using cryoablation. No complications. No recurrence of tachycardia during the follow-up period.
Slow AV nodal pathway cryoablation may be safely performed, with good short and medium-term outcomes in patients under 15 kg.
房室结折返性心动过速（AVNRT）在婴儿期并不常见。虽然导管消融 AVNRT 在儿科已被证明相对安全，但对于体重<15kg 的儿童，很少有指征进行该手术。
回顾性分析了 7 例<1 岁的 AVNRT 患儿，这些患儿需要导管消融进行明确治疗。计划使用两个或三个导管进行电生理（EP）研究。消融区域由电压标测、传播窦性波碰撞和慢径路电位定位确定。使用冷冻能量进行消融。未使用透视。
表现从妊娠 36 周至 11 个月不等。其中 2 例在胎儿期出现，2 例在新生儿期出现。消融的中位年龄为 20 个月（范围 17-31 个月）。消融时的中位体重为 11.4kg（范围 8.9-14.9kg）。中位随访时间为 16 个月。所有患者均有典型的 AVNRT。心动过速周期长度的中位数为 216ms。使用冷冻消融的成功率为 100%。无并发症。随访期间无心动过速复发。
对于体重<15kg 的患者，慢房室结径路冷冻消融可能是安全的，具有良好的短期和中期结果。
