临床儿科杂志 ›› 2025, Vol. 43 ›› Issue (12): 968-970.doi: 10.12372/jcp.2025.25e1232

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脉冲场消融在儿童心律失常领域的临床应用及展望

吕铁伟   

  1. 重庆医科大学附属儿童医院心血管科(重庆 400014)
  • 收稿日期:2025-10-09 录用日期:2025-10-13 出版日期:2025-12-15 发布日期:2025-11-28

Clinical application and prospect of pulsed field ablation in the field of pediatric arrhythmia

LYU Tiewei   

  1. Department of Cardiology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
  • Received:2025-10-09 Accepted:2025-10-13 Published:2025-12-15 Online:2025-11-28

摘要:

脉冲场消融(PFA)是心脏电生理学领域的一种革新性非热能消融策略,其通过高强度、超短程的电场脉冲导致细胞不可逆电穿孔(IRE),从而实现精准的心肌组织消融。该技术的安全性和可行性已在成人房性心律失常(特别是心房颤动)治疗中得到充分验证,但在儿科领域的临床研究和应用明显滞后。目前儿科应用面临三大核心挑战:专属临床证据的空白、适用于儿童心脏结构的专用导管缺失、以及儿童不断发育且常伴先天性异常的特殊解剖结构所带来的操作与安全考量。本文对PFA的技术原理与应用现状进行简要回顾,着重探讨其在儿童心律失常治疗中面临的关键问题与解决路径,以期增进同行对这一前沿技术的了解,并推动PFA技术在儿科领域的规范应用。

关键词: 脉冲场消融, 心律失常, 儿童

Abstract:

Pulsed field ablation (PFA) represents a transformative non-thermal therapeutic approach in interventional electrophysiology, characterized by its mechanism of inducing irreversible electroporation (IRE) through the delivery of high-intensity, ultrashort electric field pulses to achieve precise myocardial tissue ablation. The safety and feasibility of this technology have been thoroughly validated in the treatment of adult atrial arrhythmias, particularly atrial fibrillation. However, clinical research and application in the pediatric field have significantly lagged behind. Key barriers to its pediatric application include a pronounced scarcity of dedicated clinical evidence, the unavailability of catheter technologies tailored to the anatomical peculiarities of the developing heart, and unique procedural and safety challenges associated with the dynamic and often congenitally abnormal cardiac anatomy in children. This review summarizes the mechanistic foundations and current clinical landscape of PFA, with an emphasis on analyzing the central challenges and potential strategic solutions for its implementation in pediatric arrhythmia management. Meanwhile, this short review is to facilitate a deeper understanding of this emerging technology among pediatric clinicians, and to accelerate its standardized and evidence-based integration into pediatric practice.

Key words: pulsed field ablation, arrhythmia, child

中图分类号: 

  • R72