CATHETER ABLATION THERAPY FOR SUPRAVENTRICULAR TACHYCARDIA IN CHILDREN

儿童室上性心动过速的导管消融治疗

• 批准号: 05670705
• 负责人: SUMITOMO Naokata
• 金额: $ 1.02万
• 依托单位: Nihon University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 1995
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05670705/
• 关键词: SUPRAVENTRICULAR TACHYCARDIA; CATHETER ABLATION; ACCESSORY PATHWAY

Fourteen cases of supraventricular tachycardia with manifest or concealed Wolff-Parkinson-White syndrome in children were performed radiofrequency catheter ablation. The optimal size of catheter was 7 French in patients over 10 years old, and 6 French in patients less than 10 years old. Accessory pathway potential were recorded in 5 of 6 cases. The position of accessory pathway potential and earliest atrial activation site were not always same. Radiofrequency accessory pathway ablation were succeeded in all cases who were recorded accessory pathway potential. Total energy for ablation was 20 to 40 Watt sec. All cases succeeded ablation in a few seconds. Ablation were succeeded in 2 of 4 right pathways and 6 of 10 left pathways. Ablation were succeeded in 4 of 9 (44%) manifest pathways and 4 of 5 (80%) concealed pathways. However it was unsuccessful in septal and multiple pathway. Success rate was 8 of 14 cases (57%) , 8 of 15 pathways (53%). The successful ablation site was 1) Kent potential documentation, 2) A wave amplitude equal and over 0.4 mV,3) A/V ratio equal and over 0.2,4) shortest VA or QA interval measured from peak V wave to peak A wave during tachycardia or ventricular pacing. However there were no absolute optimal site if we use these indexes. Moderate aortic regurgitation was detected in one case after ablation. This complication was not due to ablation method but due to inflexibility of catheter. Catheter ablation was useful therapy for supraventricular tachycardia in children.

本文报告14例儿童室上性心动过速合并明显或隐匿性预白色综合征的射频消融治疗。10岁以上患者的最佳导管尺寸为7 French，10岁以下患者的最佳导管尺寸为6 French。6例中5例记录到旁道电位。旁路电位的位置和最早心房激动部位并不总是相同的。所有记录到旁道电位的患者均成功消融旁道。消融总能量为20 - 40 W/s。所有病例均在几秒钟内成功消融。4例右径路消融成功2例，10例左径路消融成功6例。9条显性径路中4条（44%）消融成功，5条隐性径路中4条（80%）消融成功。但间隔和多径路手术均未成功。成功率为8/14例（57%），8/15条路径（53%）。成功消融部位为：1）记录到肯特电位; 2）A波振幅等于或大于0.4 mV; 3）A/V比值等于或大于0.2;但是，如果我们使用这些指标，没有绝对的最佳网站。1例消融后检测到中度主动脉瓣返流。这种并发症不是由于消融方法，而是由于导管的可扩展性。导管消融术是治疗儿童室上性心动过速的有效方法。

项目成果

牛丿濱大也、住友直方、堀切千賀子、他: "頻拍の成立に房室結節の遅伝導路の伝導遅延を必要とした房室回帰性頻拍の1例" 日本小児科学会誌. 100. (1996)

Daiya Ushihama、Naokata Sumitomo、Chikako Horikiri 等：“房室复发性心动过速需要房室结慢传导通路传导延迟才能形成心动过速”，日本儿科学会杂志 100。（1996 年） ）

住友直方、牛ノ濱大也、唐沢賢祐、他: "小児房室回帰性頻拍に対する高周波アブレーション" 日本小児科学会誌. 97. 959-964 (1993)

Naokata Sumitomo、Daiya Ushinohama、Kensuke Karasawa 等人：“射频消融治疗小儿房室复发性心动过速”日本儿科学会杂志 97. 959-964 (1993)。

牛ノ濱大也、住友直方、山下恒久、他: "膜様部心室中隔欠損に合併した心室頻拍に高周波カテーテルアブレーションを施行した1例" 心電図. 16(発表予定). (1996)

Daiya Ushinohama、Naokata Sumitomo、Tsunehisa Yamashita 等人：“高频导管消融治疗与膜性室间隔缺损相关的室性心动过速病例”16（待出版）。

Hiroya Ushinohama, Naokata Sumitomo, Tunehisa Yamashita, Hiroyuki Izumi, Kensuke Harada: "Radiofrequency catheter ablation to ventricular tachycardia with membranous ventricular septal defect" Jpn.J.of Electrocardiology. 16 (in press). (1996)

Hiroya Ushinohama、Naokata Sumitomo、Tunehisa Yamashita、Hiroyuki Izumi、Kensuke Harada：“射频导管消融治疗膜性室间隔缺损室性心动过速”Jpn.J.of Electrocardiology。

牛ノ濱大也、住友直方、堀切千賀子、他: "頻拍の成立に房室結節の遅伝導路の伝導遅延を必要とした房室回帰性頻拍の1例" 日本小児科学会誌. 100(発表予定). (1996)

Daiya Ushinohama、Naokata Sumitomo、Chikako Horikiri 等人：“房室复发性心动过速需要房室结慢传导通路传导延迟才能建立心动过速的病例”日本儿科学会杂志 100（演示文稿预定 100） ）（1996）。