Catheter ablation of supraventricular tachycardia without fluoroscopy during pregnancy

Obstetrics and Gynecology
Amee M BigelowJohn Clark

Abstract

Although uncommon, supraventricular tachycardia is difficult to manage during pregnancy. Catheter ablation traditionally has been deferred owing to radiation exposure risks. Three-dimensional mapping is a new tool in cardiac electrophysiology, which is being utilized to eliminate fluoroscopy during catheter ablation. We report a case of ablation of supraventricular tachycardia during pregnancy without using fluoroscopy. A 27-year-old woman with a 22-week twin gestation was referred for incessant supraventricular tachycardia. Medical management with propranolol and flecainide was unsuccessful. An electrophysiology study was performed with catheter navigation guided by a three-dimensional mapping system instead of fluoroscopy. The patient underwent successful cryoablation. The procedure was performed without fluoroscopy or sedation. The patient delivered healthy twins at 35 weeks of gestation without complications. On follow-up at 26 months, she showed no evidence of recurrence. New tools in electrophysiology now make curative procedures more readily available to pregnant women and safer for the fetus.

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Citations

Jun 1, 2016·The American Journal of Emergency Medicine·Ersin SaricamNadir Barindik
Dec 5, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Amee M BigelowJohn M Clark
Nov 11, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Andrea SarkozyUNKNOWN ESC Scientific Document Group
Oct 18, 2019·Pacing and Clinical Electrophysiology : PACE·Meng-Meng LiChang-Sheng Ma
Sep 9, 2020·Pacing and Clinical Electrophysiology : PACE·Nadia Chaudhry-WatermanMitchell I Cohen
Nov 11, 2018·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Bradley C ClarkRobert H Pass
Dec 22, 2020·Obstetric Medicine·Priyanka Kugamoorthy, Danna A Spears
Mar 31, 2021·Herzschrittmachertherapie & Elektrophysiologie·Adele GreylingSabine Ernst

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