Zero-fluoroscopy catheter ablation of severe drug-resistant arrhythmia guided by Ensite NavX system during pregnancy

Abstract

Background:Cardiac arrhythmias can occur during pregnancy. Owing to radiation exposure and other uncertain risks for the mother and fetus, catheter ablation has rarely been performed and is often delayed until the postpartum period. We reported 2 pregnant women who were experiencing severe arrhythmias and were successfully ablated without fluoroscopic guidance. We also carried out a literature review of cases of pregnant women who underwent zero-fluoroscopy ablation.Methods and Results:One woman had drug-resistant and poorly tolerated frequent premature ventricular contraction (PVC) and ventricular tachycardia (VT). The other one had persistent and hardly terminated supraventricular tachycardia (SVT) via a right accessory pathway. The 2 patients were successfully underwent zero-fluoroscopy ablation guided by Ensite NavX system. The procedure time was 42 and 71 minutes, respectively.Conclusion:Catheter ablation of SVT or PVC/VT in pregnant patients can be safely and effectively performed with a completely zero-fluoroscopy approach guided by the Ensite NavX system. In the case of a drug refractory, life-threatening arrhythmia during pregnancy, catheter ablation may be considered.

Zero-fluoroscopy approach for ablation of supraventricular tachycardia using the Ensite NavX system: a multicenter experience

“…Medical staffs who wear lead garments also reduce exposure to ionizing radiation; however, heavy lead apparel increases workplace discomfort and the risk of neck, back, and joint complications. Some studies have confirmed that interventional cardiologists had experienced an alarming incidence of spinal complaints [16]. Intracardiac echocardiography (ICE) has allowed identification of anatomic structures and potential anatomic variations, and has served to guide catheter navigation, which minimized radiation exposure to operators and patients [17].…”

State of Fluoroless Procedures in Cardiac Electrophysiology Practice

“…Procedural times were consistent with previous reports on nonpregnant patients undergoing the same procedure. [58][59][60][61][62][63][64][65][66][67][68] The ablation of ventricular arrhythmias in two pregnant patients, one with idiopathic right ventricular outflow-tract (RVOT) VPC and the other with VT (RVOT anterior) due to electrical storm in ARVC, were also successfully performed with the use of three-dimensional EAM.…”

Management of pregnant women with rhythm and conductivity disorders

“…Электрическая кардиоверсия применяется при неэффективности медикаментозной терапии или в экстренных случаях. Имплантируемые кардиовертеры-дефибрилляторы используются у пациенток с высоким риском развития вне зап ной сердечной смерти вследствие необратимых причин [21][22][23].…”