预激性心肌病射频消融治疗1例报告并文献复习  

Radiofrequency ablation for preexcitation cardiomyopathy: a case report and literature review

作　　者：刘国林 许欣 刘茜[1] 刘云黎[1] 明黎 易岂建[1] 吕铁伟[1] LIU Guolin;XU Xin;LIU Qian;LIU Yunli;MING Li;YI Qijian;LYU Tiewei(Ministry of Education Key Laboratory of Child Development and Disorders,National Clinical Research Center for Child Health and Disorders,China International Science and Technology Cooperation base of Child development and Critical Disorders,Children’s Hospital of Chongqing Medical University,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院心内科,儿童发育疾病研究教育部重点实验室,国家儿童健康与疾病临床医学研究中心,儿童发育重大疾病国家国际科技合作基地,儿科学重庆市重点实验室,重庆400014

出　　处：《临床儿科杂志》2020年第7期505-507,511,共4页Journal of Clinical Pediatrics

摘　　要：目的探讨儿童预激性心肌病的发病机制、诊断及射频消融治疗效果。方法回顾分析1例确诊为预激性心肌病患儿的临床资料。结果 12岁男性患儿,体表心电图示B型预激综合征;心脏彩超示扩张型心肌病,病程中无心动过速发作;电生理检查示右后间隔旁道。射频消融术后,心电图提示delta波消失,心脏超声显示左心室缩小及心功能改善,且临床症状明显好转。结论预激导致左心室兴奋-机械收缩偶联不同步可能是预激性心肌病最重要的发病机制,以右侧间隔部显性旁道最多见。射频消融治疗有效,预后良好。Objective To explore the pathogenesis,diagnosis and radiofrequency ablation effect of preexcitation cardiomyopathy in children.Method The clinical data of a preexcitation cardiomyopathy in a child was analyzed retrospectively.Results In a 12-year-old boy,electrocardiogram showed type B Wolff-Parkinson-White syndrome.Echocardiography showed dilated cardiomyopathy without tachycardia attack during the course of the disease.Electrophysiological examination revealed right posterior septal accessory pathway.After radiofrequency ablation,electrocardiogram showed that the delta wave disappeared and echocardiography showed that the left ventricle size shrank and the cardiac function improved and the clinical symptoms were significantly improved.Conclusion The non-synchronization of excitation-mechanical contraction coupling in left ventricle caused by ventricular preexcitation may be the most important pathogenesis of preexcitation cardiomyopathy,in which the overt accessory pathway in the right septum is the most common.Radiofrequency ablation is effective and has a good prognosis.

关 键 词：预激性心肌病 导管消融术 旁道 儿童 

分 类 号：R725.4[医药卫生—儿科]