Objective: To evaluate the clinical effect and summarize the experience of radiofrequency catheter ablation (RFCA) for children suffered from premature ventricular contractions (PVCs). Methods: This retrospective study was conducted by descriptive analysis. A total of 108 cases with frequent PVCs from Shanghai Children's Medical Center were treated with RFCA under the guidance of CARTO3 system from January 2011 to December 2016. The immediate success rate of the procedure, the recurrence rate and the perioperative complications were summarized. The constituent ratio of different PVCs origins, the trend of overall procedure time and success rate in recent years were analyzed. Statistical analyses were performed using F test. Results: Immediate success of RFCA was achieved in 104 cases (96.3%, 104/108) and 4 cases (3.7%, 4/108) failed. The PVCs recurred during follow-up of over 6 months in 5 cases (4.8%, 5/104) . There were no severe complications related to the procedure. The sites of PVCs origin, in 52 cases originated from right ventricular outflow track (48.2%, 52/108) , 17 cases originated from left ventricular outflow track (15.7%, 17/108) and 26 cases originated from tricuspid annulus (24.1%, 26/108) . Among the three predilection sites of PVCs, the operation time was (141±46) min for right ventricular outflow track, (155±50) min for left ventricular outflow track, and (166±57) min for tricuspid annulus. However, the difference was not statistically significant (F=1.79, P=0.17) . X-ray exposure time was (14±8) minutes for right ventricular outflow track ablation, (32±14) minutes for left ventricular outflow track ablation and (16±8) minutes for tricuspid annulus ablation respectively. The exposure time for the ablation on left ventricle was significantly longer than the other two sites (F=5.12, P=0.018) . Conclusion: RFCA is safe and effective for PVCs in children with high success rate and low recurrence and complication rates.
目的： 分析儿童室性期前收缩经导管射频消融治疗临床效果。 方法： 采用回顾性研究，描述性分析方法，对108例上海交通大学医学院附属上海儿童医学中心2011年1月至2016年12月收治不同年龄段的频发室性期前收缩患儿采用三维CARTO3系统指导下的标测和消融，总结手术即刻成功率、复发率、围手术期并发症、不同室性期前收缩起源部位的构成比、近年消融手术成功率和手术持续时间变化趋势。组间比较采用F检验。 结果： 即刻成功104例（96.3%），消融失败4例（3.7%），平均随访半年以上，复发5例（4.8%），无重大手术相关并发症。异位起搏点分布中，来源于右室流出道52例（48.2%），左室流出道17例（15.7%，17/108），三尖瓣环26例（24.1%）。手术时间右室流出道为（141±46）min，左室流出道为（155±50）min，三尖瓣环为（166±57）min，差异无统计学意义（F=1.79，P=0.17）。辐射曝光时间右室流出道为（14±8）min，左室流出道为（32±14）min，三尖瓣环为（16±8）min，左室消融使用辐射曝光时间明显高于其他部位（F=5.12，P=0.018）。 结论： 儿童室性期前收缩经导管射频消融治疗临床成功率高，并发症及复发率低，具有良好的有效性及安全性。.
Keywords: Catheter ablation; Retrospective studies; Ventricular premature complexes.