射频消融术在儿科室上性心动过速中的应用

目的探讨射频消融术(radiofrequency catheter ablation，RFCA)在儿科阵发性室上性心动过速(paroxysmal superaventricular tachycardia，PSVT)中的应用特点，明确儿科PSVT心内电生理机制及其检查的特殊性。方法筛选1995年～2003年住院的25例18岁以下的PSVT患者，接受心内电生理检查及RFCA术，根据年龄与合作程度采用局麻或全身麻醉。结果25例患者经心内电生理检查，2例属房性心动过速，10例有房室结双径路，16例有旁道，其中3例同时具有旁道及房室结双径路。所有患者均行RFCA术治疗。结论RFCA作为一项治疗儿科心律失常的新技术，临床证明安全、有效，但由于青少年患者特殊的解剖生理特点，仍应严格掌握适应证，不断完善诊治技术、麻醉方式和防护措施。

Radiofrequency catheter ablation in pediatric supraventricular tachycardia

Objective To investigate the result of RFCA and electrophysiologic characteristics in pediatric PSVT. Methods Electrophysiologic study and RFCA were performed in 25 patients(age<18 years) with PSVT. Selection of local or general anesthesia was based on age and compliance with medical treatment. Results In 25 patients, electrophysiologic study showed that the type of SVT was atrial tachycardia (2 patients) and atrio-ventricular nodal reentry tachycardia (10 patients) and atrio-ventricular reentry tachycardia (16 patients). 3 patients with AVRT had dual atrio-ventricular nodal pathway. RFCA was then porformed in all 25 patients. Conclusion RFCA for PSVT patients were useful high reliable and safe, but special attention should be paid to the indication of RFCA, together with method of narcosis and protection.