Radiofrequency catheter ablation without radiation exposure in a 13th week pregnant woman with Wolff-Parkinson-White syndrome

Catheter ablation for tachyarrhythmias during pregnancy

“…Tachyarrhythmias occurred before pregnancy in 24 (42.9%) patients [ 3 , 7 , 8 , 11 , 13 , 21 , 25 , 27 – 29 , 31 , 36 ] and they occurred during pregnancy in 32 (57.1%) patients [ 2 , 3 , 14 , 16 , 17 , 19 , 24 – 26 , 30 , 33 , 35 , 37 ], whereas the onset time was unspecified for 72 patients. No difference was found in the prevalence of tachyarrhythmic onset between before and during pregnancy (χ 2 = 2.286, p = 0.093).…”

“…The clinical presentations were described for 34 patients. One of them was asymptomatic [ 4 ], and 33 patients had a total of 60 clinical presentations, including palpitations in 24 (40%) [ 1 – 3 , 7 , 11 , 13 , 15 , 17 , 19 – 21 , 26 – 28 , 30 , 31 , 33 , 35 , 36 ], dyspnea in 6 (10%) [ 2 , 13 , 16 , 19 , 26 , 37 ], and breathlessness/shortness of breath in 5 (8.3%) [ 26 , 31 , 35 , 37 ]. Patients’ heart rate at presentation was 202.3 ±43.7 (range: 150–300; median: 187) beats/min ( n = 31) [ 1 – 4 , 8 , 11 , 13 – 16 , 18 – 20 , 22 , 26 , 28 , 30 , 31 , 33 , 35 , 37 ].…”

“…An accessory pathway was identified in 28 patients: a left accessory pathway in 16 (57.1%) [ 3 , 12 – 14 , 20 , 24 , 29 , 30 , 32 ], a right accessory pathway in 10 (35.7%) [ 11 , 12 , 19 , 21 , 27 , 30 ], a posteroseptal accessory pathway in 1 (3.6%) [ 12 ] and a Coumel accessory pathway in 1 (3.6%) patient [ 14 ].…”

“…The ablation time was recorded for 47 patients. It was performed at 23.5 ±7.8 (range: 10–38; median: 24) weeks of gestation: in the first trimester in 7 (14.9%) patients [ 3 , 7 , 13 , 15 , 22 , 26 , 30 ], in the second trimester in 23 (48.9%) patients [ 1 – 3 , 8 , 11 , 16 , 19 – 21 , 23 – 25 , 27 , 29 – 32 , 34 , 35 , 37 ] and in the third trimester in 17 (36.2%) patients [ 3 , 4 , 11 , 13 , 14 , 17 , 18 , 23 , 28 , 30 , 33 ] (χ 2 = 12.5, p = 0.002). One of the patients had ablations twice in the third trimester due to recurrence of arrhythmia after the first ablation [ 18 ].…”

“…One of the patients had ablations twice in the third trimester due to recurrence of arrhythmia after the first ablation [ 18 ]. Ablation was performed under fluoroscopy in 21 (16.4%) patients [ 2 , 3 , 8 , 13 , 14 , 17 , 18 , 20 , 31 , 33 , 36 , 37 ], and zero-fluoroscopy technique was applied in 108 ablations of 107 (83.6%) patients [ 1 , 3 , 4 , 7 , 11 , 12 , 15 , 16 , 19 , 21 – 30 , 32 , 34 , 35 ] (χ 2 = 115.6, p < 0.001). The fluoroscopic exposure lasted 322.8 ±439.1 (range: 55–1,776; median: 109) s ( n = 15), and the radiation dose was reported for 16 patients, with a mean of 9.6 ±10.3 (range: 0.1–35.1; median: 10) mGy ( n = 10).…”