射频消融术在小儿快速心律失常中的疗效分析  

Curative effect of radiofrequency catheter ablation on pediatric tachyarrhythmia

作　　者：周建华[1] 吴慧慧[2] 

机构地区：[1]湖北医药学院附属太和医院心电图室,十堰442000 [2]湖北医药学院附属太和医院普外5科

出　　处：《中国循证心血管医学杂志》2015年第2期245-247,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的分析小儿快速心律失常心电生理检查,探讨射频导管消融术（RFCA）治疗小儿快速型心律失常的效果。方法选取经心电生理学检查确诊为快速型心律失常的患儿102例,分析不同类型心律失常行RFCA及效果,比较不同年龄组RFCA治疗效果。结果 1102例患儿中,房室折返性心动过速（AVRT）58例（56.86%）,房室结折返性心动过速（AVNRT）21例（20.59%）,室性心动过速/室性期前收缩（VT/PVC）16例（15.69%）,局灶性房性心动过速（FAT）5例（4.90%）,心房扑动/切口折返性房性心动过速（AF/IRAT）2例（1.96%）。2RFCA消融治疗98例（96.08%）,消融成功94例（95.92%）,消融失败4例（4.08%）。AVRT消融治疗56例,成功率98.21%,失败率1.79%,复发率7.25%;AVNRT消融治疗20例,成功率100.00%,复发率5.00%;VT/PVC消融治疗15例,成功率86.67%,失败率13.33%,复发率7.69%;FAT消融治疗5例,成功率80%,复发率25%;AF/IRAT消融治疗2例,成功率100.00%。3〈3岁15例,消融治疗14例,成功13例（92.86%）,消融失败1例（7.14%）,复发1例（7.69%）;3~7岁28例,消融治疗27例,成功26例（96.30%）,消融失败1例（3.70%）,复发2例（7.69%）;〉7岁59例,消融治疗57例消融成功55例（96.49%）,消融失败2例（4.08%）,复发4例（7.45%）。三组患儿消融成功率、复发率比较差异无统计学意义;〈3岁患儿消融失败率明显高于其它组。结论射频消融术成功率高,复发率低,可作为小儿快速型心律失常的首选根治方法。Objective To analyze electrophysiological examination of pediatric tachyarrhythmia, and discuss the curative effect of radiofrequency catheter ablation （RFCA） on pediatric tachyarrhythmia.Methods The child patients （n=102） diagnosed with electrophysiological examination were chosen and curative effects of RFCA on different types of arrhythmia were analyzed and compared in different groups.Results ①Among 102 cases, there were 58 （56.86%） with AVRT, 21 （20.59%） with AVNRT, 16 （15.69%） with VT/PVC, 5 （4.90%） with FAT, and 2 （1.96%） with AF/IRAT. ②There were 98 （96.08%） cases accepted RFCA, which was successful in 94 （95.92%） and failed in 4 （4.08%）. There were 56 AVRT cases were treated with RFCA, and success rate was 98.21%, failure rate was 1.79% and recurrence rate was 7.25%. There were 20 AVNRT cases were treated with RFCA, and success rate was 100.00% and recurrence rate was 5.00%. There were 15 VT/PVC cases were treated with RFCA, and success rate was 86.67%, failure rate was 13.33% and recurrence rate was 7.69%. There were 5 FAT cases were treated with RFCA, and success rate was 80% and recurrence rate was 25%. There were 2 AF/IRAT cases were treated with RFCA, and success rate was 100.00%. ③Among 15 cases aged〈3, there were 14 treated with RFCA, which was successful in 13 （92.86%）, failed in 1 （7.14%） and recurrent in 1 （7.69%）. Among 28 cases aged 3-7, there were 27 treated with RFCA, which was successful in 26 （96.30%）, failed in 1 （3.70%） and recurrent in 2 （7.69%）. Among 59 cases aged〉7, there were 57 treated with RFCA, which was successful in 55 （96.49%）, failed in 2 （4.08%） and recurrent in 4 （7.45%）. The comparison in success rate and recurrence rate had no statistical significance among 3 groups, and failure rate was higher in cases aged〈3 than that in other groups.Conclusion RFCA has higher success rate and lower recurrence rate, which can be taken as the first choice for curing pediatric tachyarrhythmia.

关 键 词：快速心律失常 心电生理检查 射频消融术 

分 类 号：R541.71[医药卫生—心血管疾病]