Radiofrequency ablation of ventricular arrhythmias from the pulmonary sinus cusp in pediatric patients and the follow-up
10.3760/cma.j.cn101070-20201217-01906
- VernacularTitle:儿童肺动脉窦起源的室性心律失常射频消融治疗及随访
- Author:
Tian LIU
1
;
Dongpo LIANG
;
Dian HONG
;
Shushui WANG
;
Zhiwei ZHANG
;
Jijun SHI
;
Mingyang QIAN
;
Yufen LI
;
Shaoying ZENG
Author Information
1. 广东省心血管病研究所，广东省华南结构性心脏病重点实验室，广东省人民医院，广东省医学科学院心儿科，广州 510800
- Keywords:
Ventricular arrhythmias;
Pulmonary sinus cusp;
Radiofrequency ablation;
Child
- From:
Chinese Journal of Applied Clinical Pediatrics
2022;37(6):439-442
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the strategy and safety of the radiofrequency ablation (RFA) on ventricular arrhythmias (VAs) originating from the pulmonary sinus cusp (PSC) in pediatric patients.Methods:Retrospective study.Fifteen patients with VAs originating from the PSC who were intervened by RFA in the Department of Pediatric Cardiology, Guangdong Provincial People′s Hospital between March 2014 to July 2020 were enrolled.All the patients met the indication criteria for RFA in pediatric patients.The electrocardiogram, ablation method of ablation were analyzed.Different curved catheters were selected for RFA according to the age and weight of the patients.The catheter was then inserted in a " U" or inverted " P" shape to the PSC.The long-term effect of ablation were reviewed.Results:The mean age and body weight of 15 patients with VAs originating from the PSC were (11.6±2.6) (6-15) years and (39.9±12.2) (19-65) kg, respectively.The electrocardiogram recorded during VAs originating from the PSC showed left bundle branch block and inferior axis with monomorphic R pattern, as well as a QS-wave in aVR and aVL.The electrocardiogram characteristics varied in patients with VAs originating from the PSC.The ideal excitation point was not found in the right ventricular outflow tract or the ablation was unsuccessful in all patients, and the earliest target was mapped and RFA was successful.Among the 15 patients, the successful ablation site was in the lower regions of the PSC, involving the right cusp in 11 patients(73.3%), the anterior cusp in 3 patients(20.0%), and the left cusp in 1 patient(6.7%). The earliest potential recorded at the PSC ablation site preceded the QRS complex onset by (27.3±6.0) ms.During the follow-up period for (2.7±2.0) years, no recurrence of VAs or complications were recorded.Conclusions:Under the premise of gentle catheterization procedure and appropriate radiofrequency energy, ablation was effective, safe and with low recurrence rate to eradicate VAs originating from the PSC in children.
