儿童阵发性心动过速65例临床特征及导管射频消融效果

目的 探讨儿童不同类型心动过速的临床特点及其射频消融效果。方法 对2000年12月～2004年12月在我院住院并接受经导管射频消融术（RFCA）治疗的65例儿童快速心律失常的临床特征及RFCA治疗结果进行回顾性分析。结果 65例患者心动过速患儿中房室折返性心动过速（AVRT）28例，房室结折返性心动过速（AVNRT）25例，房性心动过速4例（其中1例合并心房扑动），特发性室性心动过速8例。RFCA治疗总成功率为92．3％（60／65），其中左侧房室旁道及AVNRT患者成功率最高，分别为100％与96％。2例患者于术后出现迟发性房室传导阻滞，经用激素治疗后完全恢复正常；无血管损伤及心包填塞等并发症发生。随访6～48个月，3例复发（占4．6％），均再次手术获得成功。结论 AVRT和AVNRT是儿童心动过速中最常见的类型，用RFCA治疗儿童快速性心律失常安全、有效。

The efficacy of radiofrequency catheter ablation and clinical analysis in 65 children with tachyarrhythmia

Objective To investigate the clinical features and efficacy of radiofrequency catheter ablation(RFCA) of paroxysmal tachycardia in children.Methods The results of ablation and clinical characteristics were retrospectively analyzed in sixty-five children with tachy-arrhythmias from December 2000 to December 2004 in our hospital.Results Of 65 patients aged 5 to 12 years with paroxysmal tachycardia,28 cases had atrioventricular reentrant tachycardia(AVRT),25 had atrioventricular node reentrant tachycardia(AVNRT),4 had atrial tachycardia(1 complicated by atrial flutter),8 children had idiopathic ventricular tachycardia(IVT).The total ablation successful rate of 65 children with tachycardias was 92.3%(60/65),The high ablation successful rate was found in patients with left pathway(100%) and AVNRT(96%).Atrial-ventricular block in 2 of 65 children(3.1% of ablation complication) occurred for short time after ablation.No severe ablation complications(such as injury of blood vessel,pericardial tamponade) occurred.During follow-up of 6-48 months,Tachycardias recurred in 3 patients(recurrence rate 4.6%),but it was cured undergoing re-operation.Conclusion(1) Radiofrequency catheter ablation in pediatric patients is safe and effective.(2) AVRT and AVNRT are the most common types of tachycardias in children.