三维标测系统指导儿童心律失常射频消融治疗

摘要

Objectives To evaluate the efficacy and safety of using 3-dimensional electroanatomical mapping system ( Carto mapping system and Ensite mapping system ) in radiofrequency catheter ablation ( RFCA ) in children with arrhythmia.Methods Twenty-two children with arrhythmia, including 9 cases of atrial tachyarrhythmia ( AT ), 4 cases of atriobentricular reentrant tachycardia ( AVRT ), 5 cases of premature ventricular contraction ( PVC ), and 4 cases of idiopathic ventricular tachycardia ( IVT ), underwent RFCA, which were guided by Carto mapping system or Ensite mapping system ( Ensite Array and Ensite NavX ).Results Under the guidance of 3-dimensional electroanatomical mapping system, the ablation site were accurately identified in all cases.There were no serious complications during and after operation.After RFCA, no cases can be irritated again.All cases were followed up for 6 to 24 months.Only one case of AT in Ensite Array had a recurrence, which can be controlled by antiarrhythic drugs.Conclusions RFCA guided by Carto mapping system or Ensite mapping system in children with arrhythmia is efficacious and safe, especially suitable for complicated, untolerated, nonsustained arrhythmias.%目的 探讨Carto系统和Ensite系统标测指导儿童心律失常射频消融(RFCA)的有效性、安全性.方法 22例心律失常患儿,包括9例房性心动过速(AT),4例房室折返性心动过速(AVRT),5例右室室性早搏(PVC),4例特发性室性心动过速(IVT),在Carto系统或Ensite系统三维标测导航下行RFCA治疗.结果 所有病例均能准确找到消融靶点,消融完毕后心动过速均未能诱发,术中无发生严重并发症.所有病例平均随访6～24个月,Ensite Array系统组1例AT病例复发,可用药物控制.结论 Carto系统和Ensite系统标测指导儿童心律失常RFCA治疗安全可行,尤其适合于疑难复杂、血流动力学不稳定或不持续的心律失常的RFCA治疗.