射频消融治疗儿童室上性心动过速的应用体会

目的　旨在探讨射频消融(RFCA)在治疗儿童室上性心动过速(SVT)中的应用价值。方法　我院自1998年8月～1999年12月用RFCA治疗小儿SVT共9例，其中男7例，女2例。年龄8～14岁。经检查无器质性心脏病。在骶管或局部麻醉下，经皮穿刺右颈内静脉、股静脉、股动脉插入四极电极导管，先行心内电生理检查明确心律失常电生理机制，后以大头导管精确定位标测，最后从小电能开始RF放电直至有效消融成功。结果　心内电生理检查结果示显性预激综合征6例(3例右侧，3例左侧)，右侧隐匿性预激综合征1例，房室结双径路1例，持续性房室交界区反复性心动过速(PJRT)1例。RFCA治疗9例SVT，8例根治，1例复发，无严重并发症发生。结论　RFCA治疗儿童SVT疗效确切，创伤小，可重复应用。对顽固性SVT病儿，需终身服抗心律失常药物及影响儿童学习者通过RFCA可得到根治。然RFCA对幼小婴儿心肌的长远影响尚待积累更多的资料。

Experience in thetreatment of supraventricular tachycardia in children by radiofrequency catheter ablation

Objective To invastigate the value of using radiofrequency catheter ablation (RFCA) of Supraventricular tachycardia (SVT) in children. Methods From August 1998 to December 1999, nine cases with SVT were treated by RFCA, age: 8 to 14 years, all patients without organic heart diseases, using caudal or local anesthesia, catheters were inserted by a percutaneous technique. Electrophysiologic study and RFCA were performed in one session, the target the was found through activation mapping and/or pace-mapping. Results Wolff-parkinson-white (WPW) 6 cases, unidiretional retrograde accessory pathway (URAP) 1 case, dual atrioventricular nodal pathway (DAVNP) 1 case, permanent junctional reciprocating tachycardia (PJRF) 1 case, 8 cases were successful, one case recurred, no any severe complication occurred in all 9 case. Conclusion RFCA is an effective and safe method for the treatment SVT in children.