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目的总结小儿经皮室间隔缺损(VSD)封堵术后非阵发性室性心动过速(AIVR)的发生情况,探讨其临床意义及可能的发生机制。方法 2002年10月至2011年5月,1179例VSD患儿在广东省心血管病研究所心儿科行经皮VSD封堵术(室缺封堵组),术后检出AIVR17例。在我院门诊进行动态心电图检查的1392例非介入治疗患儿(非介入组)以及在我院行房间隔缺损封堵术的患儿988例(房缺封堵组)作为对照。比较室缺封堵组与对照组间AIVR的检出情况。对室缺封堵组9例患儿进行治疗,并对17例患儿进行随访。结果室缺封堵组术后动态心电图AIVR检出率高于非介入组,差异有统计学意义(P<0.05);次日常规心电图AIVR检出率高于房缺封堵组(P<0.05)。室缺封堵组所有AIVR患儿封堵术后1个月动态心电图均无AIVR,随访中无不良事件发生,随访心电图无AIVR。结论室缺封堵组封堵术后AIVR检出率高于对照组,其发生与VSD封堵有关。该病多无自觉症状,预后良好,可能无须治疗。
Objective To summarize the incidence of non-paroxysmal ventricular tachycardia (AIVR) after transcatheter closure of pediatric percutaneous ventricular septal defect (VSD) and to investigate its clinical significance and possible mechanism. Methods From October 2002 to May 2011, 1179 children with VSD were treated with percutaneous VSD occlusion in the pediatrics department of Guangdong Provincial Cardiovascular Institute. Seventy AIVR cases were detected after operation. A total of 1392 non-interventional treatment children (non-intervention group) and 988 children with atrial septal defect occlusion in our hospital (control group) were enrolled in our hospital for dynamic electrocardiogram examination. Compare the detection of AIVR between ventricular septal occlusion group and control group. Nine patients with ventricular septum blockage were treated, and 17 children were followed up. Results The detection rate of AIVR in ambulatory non-occlusion group was significantly higher than that in non-intervention group (P <0.05). The detection rate of AIVR in routine electrocardiogram on the next day was higher than that of atrial septal block (P <0.05) ). None of the patients with AIVR in the ventricular septal occlusion group had AIVR at 1 month after closure. No adverse events occurred during follow-up, and no AIVR was followed up. Conclusions The detection rate of AIVR in the occlusion group is higher than that in the control group, which is related to the occlusion of VSD. The disease more without symptoms, the prognosis is good, may not need treatment.