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目的 探讨射频消融术 (radiofrequencycatheterablation ,RFCA)在儿科阵发性室上性心动过速 (paroxysmalsuperaventriculartachycardia ,PSVT)中的应用特点 ,明确儿科PSVT心内电生理机制及其检查的特殊性。方法 筛选 1995年～ 2 0 0 3年住院的 2 5例 18岁以下的PSVT患者 ,接受心内电生理检查及RFCA术 ,根据年龄与合作程度采用局麻或全身麻醉。结果 2 5例患者经心内电生理检查 ,2例属房性心动过速 ,10例有房室结双径路 ,16例有旁道 ,其中 3例同时具有旁道及房室结双径路。所有患者均行RFCA术治疗。结论 RFCA作为一项治疗儿科心律失常的新技术 ,临床证明安全、有效 ,但由于青少年患者特殊的解剖生理特点 ,仍应严格掌握适应证 ,不断完善诊治技术、麻醉方式和防护措施。
Objective To investigate the application characteristics of radiofrequencycatherarablation (RFCA) in pediatric paroxysmalsuperaventriculartachycardia (PSVT) and to determine the electrophysiological mechanism of pediatric PSVT and its specificity. Methods Twenty-five PSVT patients under 18 years old hospitalized from 1995 to 2003 were enrolled in this study. Cardiac electrophysiological examination and RFCA were performed. Local anesthesia or general anesthesia was performed according to age and degree of cooperation. Results Twenty-five patients underwent electrophysiological examination, 2 cases of atrial tachycardia, 10 cases of atrioventricular node dual pathways, and 16 cases of bypass. Among them, 3 cases had bypass and atrioventricular node dual pathways. All patients underwent RFCA surgery. Conclusion RFCA is a new technique to treat pediatric arrhythmia. It is clinically proven to be safe and effective. However, due to the special anatomic and physiological characteristics of adolescent patients, RFCA should be strictly controlled and the diagnosis and treatment techniques, anesthesia methods and protective measures should be improved.