Radiofrequency catheter ablation therapy used in 123 children with drug - refractory tachycardia arrhythmias
10.3760/cma.j.issn.2095-428X.2015.13.008
- VernacularTitle:射频消融手术治疗婴幼儿快速性心律失常123例
- Author:
He JIANG
;
Xiaomei LI
;
Yanhui LI
;
Yan ZHANG
;
Haiju LIU
- Publication Type:Journal Article
- Keywords:
Tachycardia arrhythmia;
Radiofrequency catheter ablation;
Infant
- From:
Chinese Journal of Applied Clinical Pediatrics
2015;(13):988-991
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of radiofrequency catheter ablation(RFCA)in chil-dren with tachycardia arrhythmias. Methods One hundred and twenty - three children under 3 years old with drug -refractory tachycardia underwent an interventional electrophysiology procedure and RFCA in Medical Center of Tsinghua University from April 1994 to December 2014,including 98 male and 25 female,and their average age was(22. 9 ± 9. 6)months(2 - 35 months)and body weight was(13. 64 ± 2. 80)kg(4. 66 - 19. 40 kg). The mechanism,RFCA methods,the success rate,recurrence rate and complication rate of the different types of tachycardia were investigated. Results Among these children,interventional electrophysiological study confirmed 94 cases(76. 4% ,94 / 123 cases) with atrioventricular reentrant tachycardia(AVRT),7 cases(5. 7% ,7 / 123 cases)with atrioventricular nodal reentrant tachycardia(AVNRT),3 cases(2. 4% ,3 / 123 cases)with focal atrial tachycardia(FAT),8 cases(6. 5% ,8 / 123 ca-ses)with atrial flutter(AF),5 cases(4. 1% ,5 / 123 cases)with idiopathic left ventricular tachycardia(ILVT),6 ca-ses(4. 8% ,6 / 123 cases)arrhythmia was not induced. RFCA was performed in 109 cases(88. 6% ,109 / 123 cases). The success rate of RFCA was 94. 5%(103 / 109 cases)and the recurrence rate was 6. 8%(7 / 103 cases). In 88 cases of AVRT,the success rate was 96. 6%(85 / 88 cases),and the recurrence rate was 8. 2%(7 / 85 cases). In 5 cases of AVNRT,the success rate was 100. 0%(5 / 5 cases). In 3 cases of FAT,the success rate was 33. 3%(1 / 3 cases). In 8 cases of AF,the success rate was 87. 5%(7 / 8 cases). In 5 cases of ILVT,the success rate was 100. 0%(5 / 5 cases), and there was no recurrence. The complication of RFCA was puncture vascular occlusion in 2 cases(1. 6% ,2 / 123 ca-ses),without other serious complications and death cases. In this group of children,the fluoroscopy exposure time was (11. 2 ± 5. 8)min(5. 7 - 18. 2 min)and dose area product(DAP)exposure was(954. 5 ± 117. 4)mGy × cm2(707 -2 201 mGy × cm2 ). Compared with the elder children(379 cases over 3 years old)of the exposure fluoroscopy time (10. 8 ± 6. 4)min(3. 9 - 20. 5 min)and DAP exposure(927. 5 ± 193. 4)mGy × cm2(439 - 3 201 mGy × cm2 ),there was no statistically significant difference(t = 0. 616,1. 463,all P ﹥ 0. 05). Conclusions AVRT was the most common type of arrhythmia in infants and a higher incidence of multiple accessory pathways was found in infants. Application of radiofrequency ablation to children with tachycardia arrhythmias can be relatively safe and effective to the infants with drug - resistant tachycardia.
