Ablation of Severe Drug‐Resistant Tachyarrhythmia During Pregnancy
Identifieur interne : 000830 ( Main/Exploration ); précédent : 000829; suivant : 000831Ablation 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)
Url:
DOI: 10.1111/j.1540-8167.2010.01727.x
Affiliations:
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<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>
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