CAJ | 학술논문

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。
목적：분석소인쾌속심률실상심전생리검사，탐토사빈도관소융술（RFCA）치료소인쾌속형심률실상적효과。방법선취경심전생이학검사학진위쾌속형심률실상적환인102례，분석불동류형심률실상행RFCA급효과，비교불동년령조RFCA치료효과。결과①102례환인중，방실절반성심동과속（AVRT）58례（56.86%），방실결절반성심동과속（AVNRT）21례（20.59%），실성심동과속/실성기전수축（VT/PVC）16례（15.69%），국조성방성심동과속（FAT）5례（4.90%），심방복동/절구절반성방성심동과속（AF/IRAT）2례（1.96%）。②RFCA소융치료98례（96.08%），소융성공94례（95.92%），소융실패4례（4.08%）。AVRT소융치료56례，성공솔98.21%，실패솔1.79%，복발솔7.25%；AVNRT소융치료20례，성공솔100.00%，복발솔5.00%；VT/PVC소융치료15례，성공솔86.67%，실패솔13.33%，복발솔7.69%；FAT소융치료5례，성공솔80%，복발솔25%；AF/IRAT소융치료2례，성공솔100.00%。③＜3세15례，소융치료14례，성공13례（92.86%），소융실패1례（7.14%），복발1례（7.69%）；3~7세28례，소융치료27례，성공26례（96.30%），소융실패1례（3.70%），복발2례（7.69%）；＞7세59례，소융치료57례소융성공55례（96.49%），소융실패2례（4.08%），복발4례（7.45%）。삼조환인소융성공솔、복발솔비교차이무통계학의의；＜3세환인소융실패솔명현고우기타조。결론사빈소융술성공솔고，복발솔저，가작위소인쾌속형심률실상적수선근치방법。
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.