Zero-fluoroscopy catheter ablation of concealed left accessory pathway in a pregnant woman

Zero fluoroscopy radiofrequency ablation for Typical Atrioventricular Nodal Reentrant Tachycardia (AVNRT)

“…Catheter ablation with zero/minimal fluoroscopy has been performed in the recent past [1] , [2] , [3] , [4] , [5] . However in India, to the best of our knowledge, this is the first such reported case.…”

Ablation of a left-sided accessory pathway with near-zero fluoroscopy in a 9-year-old boy

“…We used a low dose of X-rays to pass the aortic valve and place the ablation catheter on the mitral ring. Some authors have focused on the complete elimination of X-rays from the ablation procedure [ 11 ]. The question is whether the primary goal should be complete elimination or substantial reduction of radiation exposure.…”

Management of tachyarrhythmias in pregnancy – A review

“…168,203 Catheter ablation can be considered during pregnancy in cases of arrhythmia refractory to medical therapy, but this should only be considered in a center with experienced operators, and with strong consideration of a non-fluoroscopic approach, if available. [204][205][206] Assessment for need for ICD implantation should be considered early, and the decision to implant an ICD should not be impeded by pregnancy.…”

“…168 Catheter ablation can be considered during pregnancy in cases of arrhythmia refractory to medical therapy, but this should only be considered in a center with experienced operators, and with strong consideration of a nonfluoroscopic approach, if available. [204][205][206] ACC/AHA/ESC guidelines for the management of SVT recognize catheter ablation as a reasonable management option (class IIb) for refractory arrhythmias in pregnancy, as long as efforts are made to reduce radiation exposure. 12 Exposure to radiation during catheter ablation is highly variable, ranging from 727 to 3884 cGy/cm 2 for simple AVNRT, and 925 to 23,429 cGy/cm 2 for more complex procedures to treat ventricular arrhythmias or atrial fibrillation.…”