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目的通过双电极导管(标测及消融导管各1根)对房室结折返性心动过速(AVNRT)患儿进行射频消融治疗,评价其可靠性及临床应用价值。方法收集2006年5月-2010年4月在本院经心内电生理检查诊断为AVNRT、采用双电极导管射频消融治疗的AVNRT患儿21例,对其手术效果及预后进行回顾性分析。结果经射频消融治疗后的患儿跳跃延长均≥70 ms;17例诱发出持续性心动过速,4例为1、2次房室结折返。在希氏束定位和寻找靶点的过程中,3例因消融导管刺激引发短暂Ⅰ～Ⅱ度房室传导阻滞,1例出现持续性非阵发性交界性心动过速(频率96次.min-1)。病例首次均消融成功,1例复发;术中术后无并发症,0.5 a以上随访无不良反应。结论双导管射频消融治疗小儿AVNRT方法简单、成功率高、并发症少,可根治AVNRT。
Objective To evaluate the reliability and clinical value of radiofrequency catheter ablation in children with atrioventricular nodal reentrant tachycardia (AVNRT) by means of dual-electrode catheter (one for each of the standard and ablation catheters). Methods 21 patients with AVNRT diagnosed as AVNRT by dual-catheter radiofrequency catheter ablation were collected from May 2006 to April 2010 in our hospital. The clinical effects and prognosis were retrospectively analyzed. Results After radiofrequency catheter ablation, the lengthening of the children was ≥70 ms. Seventeen patients had sustained tachycardia and four patients had the first and second atrioventricular nodal reentry. During His bundle positioning and finding the target, 3 cases had transient Ⅰ ~ Ⅱ degree atrioventricular block induced by ablation catheter and 1 case had persistent non-paroxysmal borderline tachycardia (frequency 96). min-1). The cases were successfully ablated for the first time, and one case had recurrence. No postoperative complications were found during the operation. No adverse reactions were observed after 0.5 years of follow-up. Conclusion The double-catheter radiofrequency ablation is a simple, successful and safe method for pediatric AVNRT. It has fewer complications and can cure AVNRT.