Ablation of Severe Drug‐Resistant Tachyarrhythmia During Pregnancy
Identifieur interne : 000060 ( France/Analysis ); précédent : 000059; suivant : 000061Ablation of Severe Drug‐Resistant Tachyarrhythmia During Pregnancy
Auteurs : Lukasz Szumowski [Pologne] ; Ewa Szufladowicz [Pologne] ; Michał Orczykowski [Pologne] ; Robert Bodalski [Pologne] ; Paweł Derejko [Pologne] ; Andrzej Przybylski [Pologne] ; Piotr Urbanek [Pologne] ; Mariusz Ku Mierczyk [Pologne] ; Edward Ko Luk [Pologne] ; Frederic Sacher [France] ; Prashanthan Sanders [Australie] ; Joanna Dangel [Pologne] ; Michel Haissaguerre [France] ; Franciszek Walczak [Pologne]Source :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 2010-08.
English descriptors
- KwdEn :
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. (J Cardiovasc Electrophysiol, Vol. 21, pp. 877‐882, August 2010)
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DOI: 10.1111/j.1540-8167.2010.01727.x
Affiliations:
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Luk</name><affiliation wicri:level="1"><country xml:lang="fr">Pologne</country><wicri:regionArea>Medical University of Warsaw, Warsaw</wicri:regionArea><wicri:noRegion>Warsaw</wicri:noRegion></affiliation></author><author><name sortKey="Sacher, Frederic" sort="Sacher, Frederic" uniqKey="Sacher F" first="Frederic" last="Sacher">Frederic Sacher</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Hôpital Cardiologique du Haut‐Lévêque and Université Victor Segalen Bordeaux II, Bordeaux</wicri:regionArea><placeName><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Sanders, Prashanthan" sort="Sanders, Prashanthan" uniqKey="Sanders P" first="Prashanthan" last="Sanders">Prashanthan Sanders</name><affiliation wicri:level="1"><country xml:lang="fr">Australie</country><wicri:regionArea>Cardiovascular Research Centre, Royal Adelaide Hospital and the Disciplines of Medicine and Physiology, University of Adelaide, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Dangel, Joanna" sort="Dangel, Joanna" uniqKey="Dangel J" first="Joanna" last="Dangel">Joanna Dangel</name><affiliation wicri:level="1"><country xml:lang="fr">Pologne</country><wicri:regionArea>2nd Department of Obstetrics & Gynecology, Medical University of Warsaw, Warsaw</wicri:regionArea><wicri:noRegion>Warsaw</wicri:noRegion></affiliation></author><author><name sortKey="Haissaguerre, Michel" sort="Haissaguerre, Michel" uniqKey="Haissaguerre M" first="Michel" last="Haissaguerre">Michel Haissaguerre</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Hôpital Cardiologique du Haut‐Lévêque and Université Victor Segalen Bordeaux II, Bordeaux</wicri:regionArea><placeName><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Walczak, Franciszek" sort="Walczak, Franciszek" uniqKey="Walczak F" first="Franciszek" last="Walczak">Franciszek Walczak</name><affiliation wicri:level="1"><country xml:lang="fr">Pologne</country><wicri:regionArea>Institute of Cardiology, Warsaw</wicri:regionArea><wicri:noRegion>Warsaw</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="ISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><imprint><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><date type="published" when="2010-08">2010-08</date><biblScope unit="volume">21</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="877">877</biblScope><biblScope unit="page" to="882">882</biblScope></imprint><idno type="ISSN">1045-3873</idno></series><idno type="istex">2050B89E5E056DEA328289C15D27ACDA4AE58BA2</idno><idno type="DOI">10.1111/j.1540-8167.2010.01727.x</idno><idno type="ArticleID">JCE1727</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1045-3873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Wolff‐Parkinson‐White syndrome</term><term>ablation</term><term>atrioventricular (AV) node reentry</term><term>fluoroscopy</term><term>pregnancy</term><term>supraventricular tachycardia</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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. (J Cardiovasc Electrophysiol, Vol. 21, pp. 877‐882, August 2010)</div></front></TEI><affiliations><list><country><li>Australie</li><li>France</li><li>Pologne</li></country><settlement><li>Bordeaux</li></settlement></list><tree><country name="Pologne"><noRegion><name sortKey="Szumowski, Lukasz" sort="Szumowski, Lukasz" uniqKey="Szumowski L" first="Lukasz" last="Szumowski">Lukasz Szumowski</name></noRegion><name sortKey="Bodalski, Robert" sort="Bodalski, Robert" uniqKey="Bodalski R" first="Robert" last="Bodalski">Robert Bodalski</name><name sortKey="Dangel, Joanna" sort="Dangel, Joanna" uniqKey="Dangel J" first="Joanna" last="Dangel">Joanna Dangel</name><name sortKey="Derejko, Pawel" sort="Derejko, Pawel" uniqKey="Derejko P" first="Paweł" last="Derejko">Paweł Derejko</name><name sortKey="Ko Luk, Edward" sort="Ko Luk, Edward" uniqKey="Ko Luk E" first="Edward" last="Ko Luk">Edward Ko Luk</name><name sortKey="Ku Mierczyk, Mariusz" sort="Ku Mierczyk, Mariusz" uniqKey="Ku Mierczyk M" first="Mariusz" last="Ku Mierczyk">Mariusz Ku Mierczyk</name><name sortKey="Orczykowski, Michal" sort="Orczykowski, Michal" uniqKey="Orczykowski M" first="Michał" last="Orczykowski">Michał Orczykowski</name><name sortKey="Przybylski, Andrzej" sort="Przybylski, Andrzej" uniqKey="Przybylski A" first="Andrzej" last="Przybylski">Andrzej Przybylski</name><name sortKey="Szufladowicz, Ewa" sort="Szufladowicz, Ewa" uniqKey="Szufladowicz E" first="Ewa" last="Szufladowicz">Ewa Szufladowicz</name><name sortKey="Urbanek, Piotr" sort="Urbanek, Piotr" uniqKey="Urbanek P" first="Piotr" last="Urbanek">Piotr Urbanek</name><name sortKey="Walczak, Franciszek" sort="Walczak, Franciszek" uniqKey="Walczak F" first="Franciszek" last="Walczak">Franciszek Walczak</name></country><country name="France"><noRegion><name sortKey="Sacher, Frederic" sort="Sacher, Frederic" uniqKey="Sacher F" first="Frederic" last="Sacher">Frederic Sacher</name></noRegion><name sortKey="Haissaguerre, Michel" sort="Haissaguerre, Michel" uniqKey="Haissaguerre M" first="Michel" last="Haissaguerre">Michel Haissaguerre</name></country><country name="Australie"><noRegion><name sortKey="Sanders, Prashanthan" sort="Sanders, Prashanthan" uniqKey="Sanders P" first="Prashanthan" last="Sanders">Prashanthan Sanders</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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