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射频导管消融术治疗小儿室性心律失常的疗效与安全性

Efficacy and safety of radiofrequency catheter ablation in younger children with ventricular arrhythmias.

作者信息

Dong Ziyan, Zhen Zhen, Yu Xia, Cui Lang, Shao Wei, Lin Li, Gao Lu, Yuan Yue

机构信息

Department of Pediatrics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Department of Cardiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.

出版信息

Front Pediatr. 2025 Apr 23;13:1555830. doi: 10.3389/fped.2025.1555830. eCollection 2025.

Abstract

BACKGROUND AND AIMS

To compare the clinical characteristics of ventricular arrhythmias (VAs) in younger vs. older children, and to explore the safety and efficacy of radiofrequency catheter ablation (RFCA) in the treatment of VAs in young children.

METHODS

General data, surgical data, and prognosis of all children with VAs who underwent RFCA at our hospital between 1 January 2005 and 31 December 2022 were retrospectively analysed. Patients were divided into two groups according to age: younger (<4 years); and older (≥4 years).

RESULTS

Data from 762 children with VAs were analysed, including 96 younger children (3.47 ± 0.75 years, 16.74 ± 3.98 kg) and 666 older children (9.44 ± 2.86 years, 38.85 ± 15.11 kg). Compared with the older group, there were more premature ventricular beats with ventricular tachycardia, earlier surgery, and more ablations under x-ray fluoroscopy in the younger group. The right ventricular outflow tract was the most common arrhythmia focus in both groups, followed by the tricuspid annulus in the younger group and the left ventricular septum in the older group. The acute success rates for younger and older children were 99.0% and 98.6%, respectively. The recurrence and complication rates in the two groups were similar, and there was no significant difference in radiation dose.

CONCLUSIONS

The safety and efficacy of RFCA in the treatment of younger children with VAs were similar to those of older children. RFCA appears to be a viable therapeutic option for young children with drug-resistant VAs.

摘要

背景与目的

比较年幼儿童与年长儿童室性心律失常(VAs)的临床特征,并探讨射频导管消融术(RFCA)治疗年幼儿童VAs的安全性和有效性。

方法

回顾性分析2005年1月1日至2022年12月31日在我院接受RFCA治疗的所有VAs患儿的一般资料、手术资料及预后。根据年龄将患者分为两组:年幼儿童(<4岁);年长儿童(≥4岁)。

结果

分析了762例VAs患儿的数据,其中年幼儿童96例(3.47±0.75岁,16.74±3.98kg),年长儿童666例(9.44±2.86岁,38.85±15.11kg)。与年长组相比,年幼儿童组室性早搏合并室性心动过速更多,手术时间更早,X线透视下消融次数更多。两组最常见的心律失常起源均为右心室流出道,年幼儿童组其次为三尖瓣环,年长儿童组其次为左心室间隔。年幼儿童和年长儿童的急性成功率分别为99.0%和98.6%。两组的复发率和并发症发生率相似,辐射剂量无显著差异。

结论

RFCA治疗年幼儿童VAs的安全性和有效性与年长儿童相似。对于药物难治性VAs的年幼儿童,RFCA似乎是一种可行的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/12055837/cce1807c875c/fped-13-1555830-g001.jpg

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