儿童和青少年快速性心律失常的临床特点

研究儿童和青少年快速性心律失常的临床特点。选择 1995～ 2 0 0 2年在我院行射频消融 (RFCA)治疗的儿童和青少年快速性心律失常患者 ,共 32 1例 ,男 2 10例、女 111例 ,年龄中位数 13.4± 3.6 (1.5～ 18)岁 ;其中 ,房室折返性心动过速 (AVRT) 2 0 4例、房室结折返性心动过速 (AVNRT) 74例、特发性室性心动过速 (IVT) 35例、房性心动过速 (AT) 5例、心房扑动 (AFL) 2例、不适当窦性心动过速 (IST) 1例。记录所有病例术前未发作心动过速及心动过速发作时的体表 12导联心电图 ,结合电生理检查 ,分析其临床特点。结果 :AVRT、AVNRT和IVT分别占6 3.6 %、2 3.1%和 10 .9%。年岁较小的儿童和青少年 ,右侧旁道较多 ,随着年龄的增加 ,左侧旁道相对越来越多。B型预激合并多旁道较常见。 35例IVT ,其中 2 3例为左室IVT ;6例为右室IVT。 12例合并先天性心脏病 ;13例并发心动过速性心肌病 ,心功能及心脏大小在RFCA术后 3～ 6个月恢复正常。结论 :①AVRT、AVNRT和IVT是儿童和青少年快速性心律失常中最常见的 3种类型。②心动过速性心肌病经早期适当的治疗是可逆的。

The Clinical Characteristics of Tachyarrhythmia in Children and Adolescents

To study the clinical characteristics of different kinds of tachyarrhythmia in children and adolescents,321(male 210,female 111) patients having tachyarrhythmia treated with radiofrequency catheter ablation(RFCA) between July , 1995 and December, 2002 were included. The median age was 13.4±3.6(1.5 ～18)years. Of the 321 patients,204 had atrioventricular reentrant tachycardia(AVRT),74 atrioventricular nodal reentrant tachycardia(AVNRT),35 idiopathic ventricular tachycardia(IVT),5 atrial tachycardia(AT),2 atrial flutter(AFL),1 inappropriate sinus tachycardia(IST). 12 lead electrocardiogram(ECG) with and without tachyarrhythmia attack were recorded in all the patients, ECG was analyzed in combination with clinical information. Results:The percentage of AVRT,AVNRT,and IVT were 63.6%,23.1% and 10.9% respectively.There were much more right sided accessory pathways(AP) than left sided APs. With the increase of age, the left sided AP became relatively more and more common. Multiple APs were more common in type B preexcitation syndrome compared with type A. Of the 35 cases with IVT, 23 was idiopathetic left ventricular tachycardia,6 right ventricular outflow tachycardia. Of the 321 cases,12 had congenital heart disease,13 cases with tachycardiac cardiomyopathy recovered completely both in cardiac function and cardiac size 3～6 months after successful ablation. Conclusions:①AVRT , AVNRT,and IVT are the 3 most common types of tachyarrhythmia in children.②After successful RFCA for tachyarrhythmia in children and adolescents with tachycardiac cardiomyopathy, cardiac function and cardiac size recover completely.