| Objective:To investigate the efficacy and safety of three-dimensional mapping system for radiofrequency catheter ablation(RFCA)of paroxysmal supraventricular tachycardia(PSVT)in children compared with two-dimensi-onal mapping system.Methods:The clinical data of 93 children with paroxysmal supraven-tricular tachycardia undergoing RFCA in the Department of Cardiology,the Second Hospital of Hebei Medical University from January 2007 to March2018 was retrospectively analyzed.65 cases used two-dimensional X-ray mapping system(two-dimensional group)and 28 cases were treated with RFCA under the guidance of three-dimensional mapping system(three-dimensional group).T test orχ2 test were used to compare the difference of success rate,recurrence rate,complication rate,X-ray dose and X-ray exposure time between the two groups.Results:1.Atrioventricular nodal reentry tachycardia(AVNRT)was the most common PSVT mechanisms(56/93,60.2%),with double pathways(54/56,96.4%)and multiple pathways in 2 cases(2/56,3.6%).Atrioventricular reentry tachycardia(AVRT)were observed in 37 patients(39.8%).Among the patients with AVRT,there were 24 left-side accessory pathways(24/37,64.9%)and 10 cases(10/37,27.0%)on the right side.Concealed accessory pathways were most common in left-side accessory pathways(14/24,58.3%).2.Among 93 children[male 48(48/93,51.6%)],the average age was(13.7±2.8)years and the average weight was(48.7±10.5)kg.The sex(male26/48,54.2%vs.22/48,45.8%),age(13.7±2.7 years vs.13.8±3.0 years)and weight(49.1±9.4kg vs.48.0±11.9kg)were similar between AVNRT and AVRT groups(P>0.05).3.In our research,8 children,in primary school age(8/93,8.6%),involved AVNRT in 3 cases and AVRT in 5 cases(left-side accessory pathways 1,right-side accessory pathways 3 and non-coronary sinus accessory pathways 1).85patients were adolescence(85/93,91.4%),including 32 patients diagnosed with AVNRT and 53 with AVRT(left-side accessory pathways 23,right-side accessory pathways 7 and bilateral accessory pathways 2).4.28 children used three-dimensional mapping system and 65 children used two-dimensional mapping system.There was no significant difference in the sex(16/28,57.1%vs.32/65,49.2%),age(13.7±2.5years vs.13.7±2.9years)and weight(47.4±7.3kg vs.49.2±11.6kg)between two groups(P>0.05).5.There was no significant difference in the success rate[93.9%(61/65)vs.100%(28/28),P>0.05],the incidence of complications[6.2%(4/65)vs.7.1%(2/28),P>0.05]and the operation time(85.2±15.7min vs.82.4±13.0 min,P>0.05)between two groups.However,the recurrence rate[12.9%(12/65)vs.0%,P<0.05],X-ray dose(5462.2±3067.9mGycm~2 vs.2233.5±1959.3 mGycm~2,P<0.05)and X-ray exposure time(4.5±2.3min vs.1.9±1.3min,P<0.05)in the three-dimensional group were lower than those in two-dimensional group.Conclusion:In children,there is no difference in operation time and suc-cess rate between two-dimensional X-ray and three-dimensional mapping sys-tem in RFCA.Both systems have shown high success rate and low incidence rate.However,our research suggests that the three-dimensional mapping sys-tem has a lower recurrence rate,X-ray dose and shorter exposure time compar-ed to the two-dimensional X-ray system. |
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