摘要
目的 探讨小儿不同类型心动过速的射频消融效果 ,构成比和相应的临床特点。方法 对 1991年 3月～ 2 0 0 0年 12月我院经射频消融治疗快速心律失常 32 0例患儿进行分析。结果 32 0例患儿 (年龄 6个月～ 16岁 )中 ,2 2 5例为旁道参与的房室折返性心动过速 (AVRT) ,其中左侧房室旁路消融成功率为 98 3% ,右侧房室旁路成功率为 93% ,房室结折返性心动过速 (AVNRT) 5 8例 ,成功率为98% ,复发率为 4 6 % ;房性心动过速和心房扑动 6例 ,成功率为 83% ,复发率为 17% ;特发性室性心动过速 (IVT) 31例 ,左室间隔部IVT成功率为 10 0 % ,右室流出道IVT成功率为 85 7% ,总复发率为12 %。并发症 1 6 % (5 / 32 0 ) ,其中Ⅲ度房室传导阻滞 2例 ,1例为左侧房室旁路 ,2个月后恢复正常 ,1例为AVNRT ;动静脉栓塞 3例 (8个月～ 3岁 ) ,静点尿激酶后缓解。 31例IVT心室速率为 15 0～ 2 40(198± 2 6 )次 /min ,QRS波时限 0 0 9～ 0 12 (0 10± 0 0 1)s,2 5例有室房分离。 2 2例室速 (VT)起源于左室 ,9例起源于右室流出道。全部 32 0例快速心律失常中 ,合并器质性心脏病 10例 ;因心动过速持续发作并发心动过速性心肌病 9例 ,其中 4例经射频消融成功治疗后心脏各项指标恢复正常。结论 小儿射频消融术是相对安全。
Objective To investigate the constituent ratio of the various types of supraventricular tachycardia (SVT), the clinical features and efficacy of radiofrequency catheter ablation of tachyarrhythmias in children Methods Three hundred twenty children with tachyarrhythmias underwent intracardiac electrophysiologic evaluation and radiofrequency catheter ablation Results Of 289 patients aged 6 months to 16 years with SVT, 225 had reentry with bypass tracts (AVRT); 58 had reentry within atrioventricular node; 6 had atrial tachycada and atrial flutter The ablation successful rate of the 289 children with SVT was 83～98% In 31 children with idiopathic ventricular tachycardia (IVT), ablation successful rate was 85 7～100% In the 320 patients, 10 children with tachyarrhythmia associated with organic heart diaease, 9 cases had myocardiopathy induced by incessant tachycardia, of whom 4 recovered after cured using radiofrequency catheter ablation In 31 children with IVT, the QRS rate ranged from 150 to 240 per minute, and QRS duration from 0 09 to 0 12 second There were separation between ventricle and atrium in 25 of 31 IVT Conclusion (1) The results of this study demonstrated that radiofrequency catheter ablation in pediatric patients is safe and effective, but we should strictly select patient in age <4 years (2) AVRT and AVNRT are the common types of SVT in children; (3) IVT in children usually shows narrow QRS complex; separation between ventricle and atrium is a strong evidence in diagnosis of IVT (4) With treatment of tachycardia, many of tachycardiac cardiomyopathies will recover The differential diagnosis should be carefully taken from an idiopathic dilated cardiomyopathy
出处
《中国介入心脏病学杂志》
2001年第3期121-124,共4页
Chinese Journal of Interventional Cardiology
关键词
电生理学
心律失常
导管消融
射频电流
儿童
Electrophysiology
Arrhythmia
Catheter ablation, Radiofrequency
Children
