Near-zero fluoroscopy implantation of dual-chamber pacemaker in pregnancy using electroanatomic mapping

Payne, Jason; Lo, Monica; Paydak, Hakan; Maskoun, Waddah

doi:10.1016/j.hrcr.2016.12.008

Cited by 18 publications

(18 citation statements)

References 16 publications

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“…Even with the use of dedicated EAM systems, a single shot of fluoroscopy is still required to determine adequate slack in the leads. 5 , 7 , 9 The use of ICE in this patient illustrates a unique opportunity in which, in addition to visualizing the lead tips wedged against the endocardium, the lead slack for both leads can be well appreciated without fluoroscopy. As this is our first case experience using ICE, we performed a single-shot fluoroscopy to confirm lead slack.…”

Section: Discussionmentioning

confidence: 98%

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Implantation of a dual-chamber permanent pacemaker in a pregnant patient guided by intracardiac echocardiography and electroanatomic mapping

Chua

Lim

Chong

et al. 2017

HeartRhythm Case Reports

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Section: Discussionmentioning

confidence: 98%

“… 2 There have been numerous reports using EAM, TEE, and TTE to guide device implantations in select patient cohorts, and some have reported minimizing fluoroscopy without any increase in procedural times. 3 , 4 , 5 , 6 , 7 , 8 …”

Section: Discussionmentioning

confidence: 99%

Implantation of a dual-chamber permanent pacemaker in a pregnant patient guided by intracardiac echocardiography and electroanatomic mapping

Chua

Lim

Chong

et al. 2017

HeartRhythm Case Reports

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“…An electroanatomic mapping model has the ability to display a His bundle cloud in 3‐D, simplifying the selection of implantation site for HBP. Some studies have reported pacemaker implantation including dual chamber and biventricular pacing with 3‐D mapping guidance with near zero fluoroscopy 10,11 . The average fluoroscopy time of 19 patients in a previous study from Silve at al 12 was 3.2 ± 2.8 minutes for placement of active fixation PM leads (n = 17) and/or ICD leads (n = 10) with the aid of 3‐D mapping system.…”

Section: Discussionmentioning

confidence: 99%

High efficiency and workflow of His bundle pacing and atrioventricular node ablation guided by three‐dimensional mapping system

Sun

Xiao

et al. 2020

Pacing Clinical Electrophis

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Background: Atrioventricular node (AVN) ablation combined with His bundle pacing is an effective strategy for permanent atrial fibrillation (AF) with rapid ventricular rate refractory to pharmacological therapy. We aimed to access the feasibility and efficiency of His bundle pacing and AVN ablation guided by three-dimensional (3-D) mapping system throughout the procedure. Methods: Eighteen patients with permanent AF with refractory rate and symptoms were referred for His bundle pacing and AVN ablation guided by 3-D mapping (CARTO3). Electroanatomic 3-D mapping of the right atrium and right ventricle was performed by the ablation catheter with CARTO 3 system, followed by the visualization of the leads for implantation and AVN ablation. Results: Implantation of His bundle and ventricular leads and AVN ablation were achieved successfully with the help of 3-D mapping in 17 patients. Selective His bundle pacing was achieved in five patients (29.4%), and the other (70.6%) were nonselective His bundle pacing. The mean procedure duration was 99.4 ± 16.4 minutes. The mean fluoroscopy time was 7.0 ± 2.6 minutes. The time spent on His lead implantation was 6.1 ± 3.2 minutes. One patient experienced AVN ablation from left side under aortic valves due to no effect of ablation in right atrium. Conclusion: His bundle pacing and AVN ablation guided by throughout real-time 3-D mapping system are of high-efficiency and feasibility.

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“…We considered the implantation of a temporary pacing lead under echocardiographic guidance or using electroanatomic mapping without the use of fluoroscopy [9]. However, with the use of the above-mentioned techniques, it is not possible to confirm that there is enough slack and that the helix has extended completely [9]. Any dosage of X-ray is potentially harmful, as there is no threshold dose.…”

Section: Discussion and Review Of Literaturementioning

confidence: 99%

Pregnancy and congenital complete atrioventricular block: management during pregnancy and periparturient period (RCD code: VII-V)

Ząbek

Małecka

Matusik

et al. 2018

Journal of Rare Cardiovascular Diseases

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Complete atrioventricular block (AVB) is rare during pregnancy. Congenital atrioventricular block is the most common type of heart block in this group of patients. About one-third of female patients with complete AVB remain asymptomatic until adulthood and may be first diagnosed during pregnancy. We present a case of a 31-year-old pregnant woman with complete AVB who was in her final stage of pregnancy. After reviewing the various advantages and disadvantages of feasible approaches with the patient, we decided to use fluoroscopy-guided temporary backup pacemaker implantation. Estimated radiation skin dose was small and safe. The patient agreed to this treatment plan. Four days prior to scheduled cesarean delivery (39 weeks of gestation), during a one-day stay in the hospital, the patient underwent single-chamber temporary pacemaker implantation (using transvenous active fixation lead and external re-sterilized pacemaker). The abdominal and pelvic regions were covered with a lead shield. The caesarean delivery was uneventful and the baby was healthy with an Apgar score of 10. JRCD 2018; 3 (6): 204-208

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Near-zero fluoroscopy implantation of dual-chamber pacemaker in pregnancy using electroanatomic mapping

Cited by 18 publications

References 16 publications

Implantation of a dual-chamber permanent pacemaker in a pregnant patient guided by intracardiac echocardiography and electroanatomic mapping

Implantation of a dual-chamber permanent pacemaker in a pregnant patient guided by intracardiac echocardiography and electroanatomic mapping

High efficiency and workflow of His bundle pacing and atrioventricular node ablation guided by three‐dimensional mapping system

Pregnancy and congenital complete atrioventricular block: management during pregnancy and periparturient period (RCD code: VII-V)

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