Celiker A, Brugada P
Arrhythmia Unit, O.L.V. Hospital Cardiovascular Center, Aalst, Belgium.
Turk J Pediatr. 1996 Oct-Dec;38(4):467-75.
Catheter ablation of an accessory pathway and atrioventricular node modification using 550 kHz radiofrequency was attempted in 23 children and adolescents between five and 19 years of age (mean = 15.7 years). Fifteen children had accessory-pathway-mediated tachycardia and eight had atrioventricular node reentrant tachycardia. Accessory pathways were present in ten children. Two patients had associated congenital heart disease. Symptoms included disabling palpitations and episodes of syncope. Ablation was attempted from the right and left sides of the heart. Single-catheter technique was used in seven patients. Eleven of the 15 patients with accessory pathways were treated completely. Two patients had recurrences, and one of them died after the arrhythmia surgery. There were two failures. Two patients with incomplete interruption of the accessory pathways were followed up clinically. There were three cases with temporary systemic embolization and one with severe pain related to radiofrequency energy application. Atrioventricular node modification was done by fast-pathway ablation in six, and by slow-pathway ablation in two patients. Two patients with fast-pathway ablation had recurrences of clinical arrhythmia, and one of them underwent a successful second session. There were no complications associated with the procedure in this group of patients. Radiofrequency catheter application was initially successful in 21 (84%) out of 25 procedures, and ultimately curative in 16 (69%) out of 23 patients. There were some serious complications which resolved in the immediate post-procedure period. Radiofrequency catheter ablation appears to be a safe and successful method for the management of supraventricular tachycardia secondary to accessory pathways or atrioventricular node reentrant tachycardia in children and adolescents.
对23名年龄在5至19岁（平均15.7岁）的儿童和青少年尝试使用550千赫兹射频进行旁路消融和房室结改良。15名儿童患有旁路介导的心动过速，8名患有房室结折返性心动过速。10名儿童存在旁路。2名患者伴有先天性心脏病。症状包括使人衰弱的心悸和晕厥发作。尝试从心脏的右侧和左侧进行消融。7名患者采用单导管技术。15名有旁路的患者中有11名得到了彻底治疗。2名患者复发，其中1名在心律失常手术后死亡。有2例失败。2名旁路未完全中断的患者进行了临床随访。有3例出现暂时性全身栓塞，1例因射频能量应用出现严重疼痛。6名患者通过快径消融进行房室结改良，2名患者通过慢径消融进行改良。2名接受快径消融的患者出现临床心律失常复发，其中1名成功进行了第二次手术。该组患者未出现与手术相关的并发症。25次手术中有21次（84%）最初射频导管应用成功，23名患者中有16名（69%）最终治愈。出现了一些严重并发症，在术后即刻得到缓解。射频导管消融似乎是治疗儿童和青少年因旁路或房室结折返性心动过速引起的室上性心动过速的一种安全且成功的方法。
