儿童房性心动过速的电生理标测和射频导管消融

目的报道儿童房性心动过速（房速）的电生理标测及射频导管消融的疗效。方法43例患儿（男性23例，女性20例），年龄2～14（7．1±3．1）岁，其中33例为无休止房速，17例伴有明显的左心室扩大及慢性心力衰竭。所有患儿均进行电生理标测，在最早激动点进行导管射频消融。结果39例自发或诱发房速，局灶起源36例（右心房26例，左心房10例），先天性心脏病后大折返房速3例。35例（89．7％）患儿消融术即刻成功，消融术中及术后无严重并发症发生。平均随访（25．2＋-13．5）个月，34例（87．2％）患儿不服药亦无房速发作，其余均获得明显改善。14例左心室重度扩大及射血分数减低患儿心脏大小及功能恢复正常。结论儿童房速可经导管消融消除或获得明显改善。

Radiofrequency catheter ablation of atrial tachycardia in children

Objective Atrial tachycardia (AT) is a common entity among children.This study was designed to investigate the effects of electrophysiological study (EPS) and radiofrequency (RF) catheter ablation of AT in children. Methods Forty-three children [ mean age: (7. 1 ± 3. 1 ) years ] with AT underwent EPS and catheter ablation. Thirty-three children had demonstrated incessant AT, and 17 children had severely dilated left ventricle (LV) and congestive heart failure before ablation. RF energy was delivered to the earliest activation site of the AT. Results Thirty-nine children have spontaneous or induced AT, 36 of them was verified as focal mechanism (26 foci in the right atrium and 10 in the left atrium),and 3 was macro-reentrant mechanism. The AT originated from right atrial appendage in 12 cases. RF ablation was acutely successful in 35 (89. 7% ) patients without any complications. During a follow-up period of ( 25.2 ± 13.5 ) months, 34/39 (87.2%) children had no recurrence of AT, and the 14 children with severe dilated LV before ablation had normal LV diameter. Conclusion RF catheter ablation is effective and safe for treatment of pediatric AT.