射频消融治疗儿童快速心律失常的并发症分析

目的　总结射频消融治疗儿童快速心律失常出现并发症的防治经验和教训。方法　射频消融(RFCA)治疗160例患儿中发生并发症9例，发生率为5.6%，其中股动脉血栓5例(3.1%)，血气胸并失血性休克、心包积液、中度主动脉瓣反流(AR)和三度房室传导阻滞各1例(0.62%)。及时分别通过动脉溶栓、输血、胸腔闭式引流、埋置永久起搏器等方法进行处理。结果　AR经药物治疗，反流程度减轻，其余经治疗后痊愈。结论　射频消融治疗儿童快速心律失常并发症比成人发生率高，与儿童心血管的解剖结构、使用成人的射频导管和电极、操作经验不足有关，严格操作规程，使用儿童的射频导管和电极，丰富的射频导管操作经验、心电生理学和影像学知识、能使并发症减少到最低限度。

Analysis of thecomplications related to the radiofrequency ablation of rapid tachyarrhythmias in children

Objective To search for the pathogenic factors, therapeutic and preventive method of complications during radiofrequency ablation of rapid tachyarrhythmias in children. Methods The complications of radiofrequency ablation occurred in 9 of 160 patients (5.6%). 9 patients included right femoral arterial thrombosis (five), pericardia effusion (one), hemopneumothorax and shock (one), moderate aortic regurgitation (one), three degree atrioventricular block (one). Various treatment modalities were done in time, included intra-arterial thrombolytic therapy, blood transfusion,removal hemothorax and pacemaker implantation. Results Aortic regurgitation reduced, the others were cured after therapy. Conclusion The incidence of complications related to the radiofrequency ablation of rapid tachyarrhythmias in children is higher than it in adults, high incidence is closely related to cardiovascular anatomical structure in children, using adult's rdiofrequency catheter and lack of experience. So the incidence of complications can be reduced as low as possible if using child's radiofrequency catheter and the operators comply with the rules of operetion, having the rich experience in radiofrequency catheter technique and knowledge of cardiac electrophysiolgy and imaging.