Ablation of severe drug-resistant tachyarrhythmia during pregnancy

Lukasz Szumowski, Ewa Szufladowicz, MichaŁ Orczykowski, Robert Bodalski, PaweŁ Derejko, Andrzej Przybylski, Piotr Urbanek, Mariusz KuŚmierczyk, Edward KoŹluk, Frederic Sacher, Prashanthan Sanders, Joanna Dangel, Michel Haissaguerre, Franciszek Walczak

Research output: Contribution to journalArticlepeer-review

59 Citations (Scopus)

Abstract

Ablation of Tachyarrhythmia During Pregnancy. Aims: The goal of this study was to describe mapping and ablation of severe arrhythmias during pregnancy, with minimum or no X-ray exposure. Treatment of tachyarrhythmia in pregnancy is a clinical problem. Pharmacotherapy entails a risk of adverse effects and is unsuccessful in some patients. Radiofrequency ablation has been performed rarely, because of fetal X-ray exposure and potential maternal and fetus complications. Group and Method: Mapping and ablation was performed in 9 women (age 24-34 years) at 12-38th week of pregnancy. Three had permanent junctional reciprocating tachycardia, and 2 had incessant atrial tachycardia. Four of them had left ventricular ejection fraction ≤45%. One patient had atrioventricular nodal reciprocating tachycardia requiring cardioversion. Three patients had Wolff-Parkinson-White syndrome. Two of them had atrial fibrillation with ventricular rate 300 bpm and 1 had atrioventricular tachycardia 300 bpm. Fetal echocardiography was performed before and after the procedure. Results: Three women had an electroanatomic map and ablation done without X-ray exposure. The mean fluoroscopy time in the whole group was 42 ± 37 seconds. The mean procedure time was 56 ± 18 minutes. After the procedure, all women and fetuses were in good condition. After a mean period of 43 ± 23 months follow up (FU), all patients were free of arrhythmia without complications related to ablation either in the mothers or children. Conclusion: Ablation can be performed safely with no or minimal radiation exposure during pregnancy. In the setting of malignant, drug-resistant arrhythmia, ablation may be considered a therapeutic option in selected cases.

Original languageEnglish
Pages (from-to)877-882
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume21
Issue number8
DOIs
Publication statusPublished or Issued - Aug 2010

Keywords

  • Wolff-Parkinson-White syndrome
  • ablation
  • atrioventricular (AV) node reentry
  • fluoroscopy
  • pregnancy
  • supraventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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