儿童经导管射频消融术的应用进展

摘要

快速性心律失常是儿童较常见的一类心律失常.持续或频繁的心动过速严重危害儿童的身心健康.在心内电生理检查的帮助下,各种心律失常的电生理机制不断阐明,同时诊疗技术也突飞猛进的发展,儿童快速性心律失常的治疗对策发生了重大变革,经导管射频消融术应运而生.经导管射频消融术是通过热效能,毁损心律失常病灶或阻断折返途径或房室传导,从而达到治疗的目的.儿童射频消融术的临床应用,彻底改变了药物治疗无法根治心律失常的历史.临床医师应全面评估心律失常对儿童的影响及可能的预后,严格掌握适应证.目前儿童房室折返性心动过速、房室结折返性心动过速、室性心动过速、房性心动过速、心房扑动的射频消融治疗已日趋成熟,成功率高,复发率低.并发症发生与手术医师的经验密切相关.%Tachyarrhythmia is a common type of arrhythmia in children.Continuous of frequent tachy cardia can bring serious harm to children's physical and mental health.With the help of electrophysiological study,electrophysiological mechanisms of various arrhythmias have been stated constantly,while the medical technology develops rapidly.The treatment strategy in pediatric arrhythinia has undergone major reforms,and radiofrequency catheter ablation has come into being.Through the thermal efficiency of the radiofrequency current,radiofrequency catheter ablation can damage the arrhythmia foci or block the atrioventricular reentrant pathway,so achieve the purpose of cure.The clinical application of radiofrequency catheter ablation can avoid the inconvenience of antiarrhymic drugs.Comprehensive assessments of the impacts and possible prognosis should be achieved by clinicians.Strict indications are very important.Currently the ablation has matured in atrioventricular re entrant tachycardia,atrioventricular nodal reentrant tachycardia,ventricular tachycardia,atrial tachycardia and atrial flutter,with high successful rate and low recurrence rate.Complications are closely related to the experience of the surgeon.