83例小儿心律失常射频消融手术治疗效果分析

摘要

目的:评价83例小儿心律失常患儿的射频消融手术治疗的临床效果.方法:回顾性的研究2009- 09- 01至2012- 06-30期间83例因心律失常在我院小儿心内科住院并接受心内电生理检查+射频消融手术治疗的患儿.83例患儿(男性59例,女性24例),平均年龄9.22岁(3.75岁~14岁),平均体重33.2公斤(15公斤~98公斤).结果:83例患儿射频消融手术治疗后随访(18±12)月.83例患儿急性期消融成功76例,成功率91.56%(76/83);随访期复发8例,复发率为9.63%(8/83).阵发性室上性心动过速54例,其中房室折返性心动过速23例;预激综合征13例;房室结折返性心动过速18例;急性期均消融成功,成功率为100%.室性早搏21例,其中右心室流出道9例,右心室流入道7例,左心室流出道4例,两种形态早搏1例;急性期18例消融成功,3例消融不成功.4例室性心动过速,均消融成功;其中1例为室间隔缺损术后,其余3例为特发性的.心房扑动2例,均为心外科开胸手术治疗术后根治,随访期无复发.房性心动过速1例,未标测到理想的靶点未予消融.1例致心律失常型右心室型心肌病术后3天即出现复发.所有患儿术后均未出现明显的并发症(无死亡,无出血).结论:在我们这个研究组中,射频消融手术被安全有效地应用于儿科患儿中,我们还需要一个更长期的随访结果.%Objectives:To assess the clinical outcomes of radiofrequency catheter ablation (RFCA) in pediatric patients with arrhythmia.rnMethods: We retrospectively studied 83 consecutive pediatric patients with arrhythmia (59 male and 24 female) who received RFCA in our hospital from September 2009 to June 2012. The patients mean age was 9. 22 (3. 75 ～ 14) years,and the average body weight was 33.2 (15～98) kg. They were followed-up for (18 ± 12) months after RFCA treatment.rnResults:The RFCA success rate was 91. 56% (76/38) in acute stage,and the recurrence rate was 9. 63% (8/83) during follow-up time. There were 54 patients of paroxysmal supra-ventricular arrhythmia including 23 cases of atrio-ventricular reentrant tachycardia, 13 of Woff-Parkinson-White syndrome and 18 of atrio-ventricular nodal reentry tachycardia,all of them (100%) had RFCA success in acute stage. There were 21 patients of premature ventricular contraction( pvc) , including 9 of right ventricular outflow PVC ,7 of right ventricular inflow PVC ,4 of left ventricular outflow PVC ,1 of two forms of PVC , and 18 patients had RFCA success in acute stage and 3 failed. 4 ventricular tachycardia patients all had RFCA success. 2 atrial flutter patients received post cardiac surgery by RFCA and with no recurrence. 1 atrial tachycardia patient did not receive RFCA since no ideal target was detected. 1 arrhythmic right ventricular caridomyopathy had recurrence on the third day after the treatment. No patient had major complications as death and hemorrhage during follow-up period.rnConclusion: In our work, RFCA was applied safely and effectively in pediatric patients with arrhythmia. Longer term of follow-up study was needed.