小儿室上性心动过速导管射频消融术后心律失常分析  

Analysis of arrhythmia in short and long term after radiofrequency catheter ablation in children with supraventricular tachycardia

作　　者：朱少辉[1] 陈水意[1] 伍彩英[1] 戴海蓉[2] 

机构地区：[1]广东省人民医院广东省医学科学院心电功能室,广州1112510080 [2]中山大学第一附属医院普内科,广州510080

出　　处：《岭南心血管病杂志》2009年第3期195-197,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨小儿室上性心动过速经导管射频消融术(radiofrequency catheter ablation,RFCA)治疗后近期和远期的心律失常情况。方法回顾性分析105例行RFCA治疗的室上性心动过速患儿的动态心电图资料,对其术后的心律失常情况进行分析。结果105例患儿术后1d～3d内有2例房性心动过速复发,发生率1.9%(2/105),其他各种类型的心律失常有:传导阻滞15例,发生率14.3%(15/105),包括9例(I度5例、II度4例)房室传导阻滞(atrioventricular block,AVB),5例完全性右束支传导阻滞,1例窦房传导阻滞;6例游走心律,3例间歇预激,3例心肌缺血。21例患儿于术后近期和远期共行47例次动态心电图检查,其中12例大致正常,2例复发的房性心动过速于远期消失,4例窦房或AVB消失,1例频发AVB变为偶发,2例新发Ⅰ度或Ⅱ度AVB。结论射频消融术治疗小儿室上性心动过速安全有效,复发率低。术后注意可能发生传导阻滞、心肌缺血等。多数传导阻滞于术后远期会有改善,但也需注意迟发性传导阻滞的发生。Objectives To analyze the arrhythmia in short and long term after radiofrequency catheter ablation （RFCA） in children with supraventricular tachycardia （SVT）. Methods Dynamic electrocardiogram （DCG） data of 105 SVT children who underwent RFCA therapy was collected, and arrhythmia after RFCA was retrospectively analyzed. Results Two atrial tachycardia （AT） recurrence was observed in 105 patients at 1 to 3 days after RFCA and the incidence was 1.9% （2/105）. Besides recurrent AT, other arrbythmia included 15 conduction block with the incidence was 14.3% （15/105） consisting of 9 atrioventricular block （AVB） , 5 complete right bundle branch block and 1 siuoatrial block; and 6 wandering rhythm, 3 intermittent pre-excitation and 3 myocardial ischemia. Forty-seven times of DCG examination were performed for 21 SVT children in short and long term after RFCA. Twelve cases showed almost normal, 2 recurrent AT vanished in long term post RFCA, 4 sinoatrial block and AVB disappeared, and 1 AVB turned from frequent to accasional. However, two de novo AVB was observed in long term post RFCA. Conclusions RFCA therapy is safe and effective with low recurrence in children. Conduction block and myocardial ischemia should be considered after RFCA. Most conduction block improves in the long term, while de novo late conduction block should be carefully observed.

关 键 词：心动过速 室上性 导管消融术 心律失常 心电描记术 儿童 

分 类 号：R541.7[医药卫生—心血管疾病]