Martínez J L, Monedero C M, Alvaro E M, Prado A P, Villacastín J P, Fernández E J, Maíz A A, Argüelles J I, Garrote J A
Departamento de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid.
Rev Esp Cardiol. 1995 Dec;48(12):820-7.
Radiofrequency ablation has been extensively used in adults to treat supraventricular and ventricular tachycardia. In children and adolescents few data are available on its safety and efficacy.
28 patients (mean age 12.8) with symptomatic tachyarrhythmias underwent catheter ablation; 21 children had atrioventricular accessory pathways (11 right connections, 9 lef connections and one midseptal pathway), 3 had intranodal tachycardia, 2 had ventricular tachycardia and 2 had atrial tachycardia. Only four patients had associated structural anomalies.
Success rate was 71.4% (20 patients). The success per cents in each group were: in intranodal tachycardias 100%; we failed in the two patients with ventricular tachycardias; in accessory pathways 76.1% and 50% in atrial tachycardia. There were no recurrences of arrhythmia in a mean chase period of 24 months (12-46). Major complications were only observed in one patient who developed a Wallenberg syndrome after ablation.
Radiofrequency catheter ablation appears to be a safe and effective method to treat arrhythmias in children and adolescents, which in most cases can supersede surgery. Alow incidence of complications is reported, although long term damage on endocardial structures remains yet to be determined.
射频消融术已在成人中广泛用于治疗室上性和室性心动过速。在儿童和青少年中，关于其安全性和有效性的数据很少。
28例有症状性心律失常的患者（平均年龄12.8岁）接受了导管消融；21例儿童有房室旁道（11例右侧连接，9例左侧连接和1例中间隔旁道），3例有结内心动过速，2例有室性心动过速，2例有房性心动过速。只有4例患者有相关的结构异常。
成功率为71.4%（20例患者）。每组的成功率分别为：结内心动过速为100%；2例室性心动过速患者手术失败；旁道为76.1%，房性心动过速为50%。在平均24个月（12 - 46个月）的随访期内，心律失常无复发。仅1例患者在消融后出现延髓背外侧综合征这一主要并发症。
射频导管消融术似乎是治疗儿童和青少年心律失常的一种安全有效的方法，在大多数情况下可取代手术。尽管心内膜结构的长期损害尚待确定，但据报道并发症发生率较低。
