目的 总结心脏扩大伴心室预激患儿的临床特点，评价射频消融（RFCA）治疗该类疾病的安全性和有效性。方法 回顾性分析2016年5月至2023年5月在心内科就诊的心脏扩大伴心室预激患儿的临床资料。结果 6例（男2例、女4例）患儿发现心脏扩大时中位年龄2.0岁，所有患儿均存在无心动过速表现的显性心室预激，且正规抗心力衰竭药物治疗后心脏大小及心功能恢复不满意。6例患儿均接受了RFCA，接受RFCA时的中位年龄为4.4岁，所有患儿术中心内电生理检查均证实存在右侧旁道，其中右侧游离壁旁道4例，右侧间隔旁道2例，其中2例为多旁道。术后随访发现所有患儿室壁运动不协调及室壁动度较前改善，术后心脏功能首先恢复，最短术后1个月恢复正常；心脏大小恢复较慢，最短1.7年恢复正常。结论 心脏扩大合并不伴有心动过速的心室预激临床多见，在药物治疗效果不佳时可尝试RFCA去除引起旁路预激的因素，RFCA不仅有助于该类疾病的诊断，也是安全、有效的治疗手段。

Objective To summarize the clinical characteristics of children with cardiac enlargement and ventricular preexcitation, and to evaluate the safety and effectiveness of radiofrequency ablation (RFCA) in the treatment of this type of disease. Methods A retrospective analysis was conducted on the clinical data of 6 children with cardiac enlargement and ventricular preexcitation in our hospital, and the clinical efficacy and follow-up of ablation treatment were analyzed. Results The median age of 6 children (2 males and 4 females) was 2.0 years at the time of detection of cardiac enlargement, all of whom had overt ventricular preexcitation without tachycardia manifestations and unsatisfactory recovery of cardiac size and cardiac function after regular anti-heart failure medication. All 6 children underwent RFCA, and the median age of the patients at the time of RFCA was 4.4 years. All of the children had intraoperative electrophysiologic examination confirming the presence of right-sided accessory pathway, including 4 cases of right free wall accessory pathway, 2 cases of right septal accessory pathway, and 2 cases of multiple accessory pathways. Postoperative follow-up found that all children had improved ventricular wall motion incoordination and ventricular wall kinematics compared with the previous ones, and postoperative cardiac function was firstly recovered and returned to normal in the shortest postoperative period of 1 month, while cardiac size recovered more slowly and returned to normal in the shortest period of 1.7 years. Conclusions Ventricular preexcitation with cardiac enlargement and no accompanying tachycardia is common in clinical practice. When drug treatment is not effective, RFCA can be attempted to remove the factors of bypass preexcitation. For the diagnosis and differential diagnosis of this type of disease, especially it is a safe and effective treatment. Cardiac enlargement combined with ventricular preexcitation without tachycardia is clinically common, and RFCA can be attempted to remove the factors that cause bypass preexcitation when medication is ineffective, and RFCA not only helps in the diagnosis of this type of disease, but it is also a safe and effective means of treatment.