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|本期目录/Table of Contents|

射频导管消融360例儿童心律失常的疗效和安全性

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2016年第1期
页码:
37-039
栏目:
临床研究
出版日期:
2015-09-15

文章信息/Info

Title:
Efficacy and safety of radiofrequency catheter ablation of arrhythmias in 360 children
作者:
金志清; 王祖禄; 孙鸣宇; 梁延春; 梁 明; 丁明英; 韩雅玲
(沈阳军区总医院全军心血管病研究所心内科，辽宁 沈阳 110840)
Author(s):
JIN Zhi-qing;  WANG Zu-lu;  SUN Ming-yu;  LIANG Yan-chun;  LIANG Ming;  DING Ming-ying;  HAN Ya-ling
(Department of Cardiology, General Hospital, Shenyang Military Area Command, Shenyang 110840, Liaoning, China)
关键词:
心律失常; 儿童; 射频导管消融
Keywords:
radiofrequency catheter ablation;  children;  arrhythmia
分类号:
R541.7
DOI:
-
文献标识码:
A
摘要:
目的 目的评价射频导管消融360例儿童心律失常的疗效和安全性。方法 回顾性分析2000年1月~2013年12月360例因心律失常在我院接受射频导管消融的儿童患者360（男213例、女147）例，年龄15个月~14（10±3）岁,平均体质量34 kg。结果 急性期消融成功率98.9%(356/360例)，4例消融失败。360例患者中，阵发性室上性心动过速308例，占85.6%，307例(99.7%)患者消融成功，其中隐匿性房室旁路伴房室折返性心动过速121例、显性旁路（预激综合征）82例、房室结折返性心动过速105例；室性心律失常42例，其中室性早搏15例（均消融成功），27例室性心动过速（其中4例并发结构性心脏病，25例消融成功）；房性心律失常10例（9例消融成功，其中典型心房扑动3例，不典型心房扑动1例，局灶性房性心动过速6例）。所有患儿围术期均未出现明重要并发症。术后随访至少12个月,随访期复发率为 2.2%（8/356例），其中6例经再次消融成功。结论 射频导管消融术治疗有适应证的心律失常儿童安全有效。
Abstract:
AIM To evaluate the efficacy and safety of radiofrequency catheter ablation (RFCA) of arrhythmias in 360 children. METHODSA total of 360 children with different types of arrhythmias undergoing RFCA in our center between 2000 and 2013 were analyzed. Among the patients, 213 children were males and 147 were females, whose ages ranged from 15 months to 14 years (mean 10.4 3.3) and average body weight was 34 kg. RESULTSThe acute success rate was 98.9% (356/360 cases). Among the 360 cases, 308 cases had paroxysmal supraventricular tachycardia (85.6%), the acute success rate being 99.7%, including 121 cases with concealed atrioventricular accessory pathway (AP) and atrioventricular reentrant tachycardia, 82 cases with preexcited AP (Wolff-Parkinson-White Syndrome) and 105 cases with atrioventricular nodal reentrant tachycardia. Forty-two cases had ventricular arrhythmias. Acute success rate was 95.2% including 15 cases with premature ventricular beats and 27 cases with ventricular tachycardia. Ten cases had atrial arrhythmias and the acute success rate was 90.0%, including three cases with typical atrial flutter, one case with atypical atrial flutter and six cases with focal atrial tachycardia. Obvious complications occurred in none of the patients during the perioperative period. During a period of at least 12 months of follow-up after ablation, arrhythmias recurred in eight cases (2.2%) and six of the eight cases had a successful re-ablation. CONCLUSIONRadiofrequency catheter ablation of arrhythmias is safe and effective in children who have indications for the procedure.

参考文献/References

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[2]Borggrefe M,Budde T,Podczeck A,et al.High frequency alternating current ablation of an accessory pathway in humans[J].J Am Coll Cardiol,1987,10(3):576-582.
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备注/Memo

备注/Memo:
收稿日期：2015-03-02.
>基金项目：辽宁省科学技术计划项目资助(2014305006)；辽宁省自然科学基金项目资助（20102247）
通讯作者：王祖禄，主任医师，主要从事心律失常诊治与研究 Email：wangzl@medmail.com.cn
作者简介：金志清，主治医师，硕士 Email：jinzhiqing12@163.com
更新日期/Last Update: 2015-09-16