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Type: Journal article
Title: Ablation of severe drug-resistant tachyarrhythmia during pregnancy
Author: Szumowski, L.
Szufladowicz, E.
Orczkowski, M.
Bodalski, R.
Derejko, P.
Przybylski, A.
Urbanek, P.
Kusmierczyk, M.
Kozluk, E.
Sacher, F.
Sanders, P.
Dangel, J.
Haissaguerre, M.
Walczak, F.
Citation: Journal of Cardiovascular Electrophysiology, 2010; 21(8):877-882
Publisher: Futura Publ Co
Issue Date: 2010
ISSN: 1045-3873
Statement of
Lukasz Szumowski, Ewa Szufladowicz, Michał Orczykowski, Robert Bodalski, Paweł Derejko, Andrzej Przybylski, Piotr Urbanek, Mariusz Ku´Smierczyk, Edward Ko´Zluk, Frederic Sacher, Prashanthan Sanders, Joanna Dangel, Michel Haissaguerre, and Franciszek Walczak
Abstract: <h4>Aims</h4>The goal of this study was to describe mapping and ablation of severe arrhythmias during pregnancy, with minimum or no X-ray exposure. Treatment of tachyarrhythmia in pregnancy is a clinical problem. Pharmacotherapy entails a risk of adverse effects and is unsuccessful in some patients. Radiofrequency ablation has been performed rarely, because of fetal X-ray exposure and potential maternal and fetus complications. GROUP AND METHOD: Mapping and ablation was performed in 9 women (age 24-34 years) at 12-38th week of pregnancy. Three had permanent junctional reciprocating tachycardia, and 2 had incessant atrial tachycardia. Four of them had left ventricular ejection fraction < or =45%. One patient had atrioventricular nodal reciprocating tachycardia requiring cardioversion. Three patients had Wolff-Parkinson-White syndrome. Two of them had atrial fibrillation with ventricular rate 300 bpm and 1 had atrioventricular tachycardia 300 bpm. Fetal echocardiography was performed before and after the procedure.<h4>Results</h4>Three women had an electroanatomic map and ablation done without X-ray exposure. The mean fluoroscopy time in the whole group was 42 +/- 37 seconds. The mean procedure time was 56 +/- 18 minutes. After the procedure, all women and fetuses were in good condition. After a mean period of 43 +/- 23 months follow up (FU), all patients were free of arrhythmia without complications related to ablation either in the mothers or children.<h4>Conclusion</h4>Ablation can be performed safely with no or minimal radiation exposure during pregnancy. In the setting of malignant, drug-resistant arrhythmia, ablation may be considered a therapeutic option in selected cases.
Keywords: ablation
atrioventricular (AV) node reentry
supraventricular tachycardia
Wolff-Parkinson-White syndrome
Rights: © 2010 Wiley Periodicals, Inc.
DOI: 10.1111/j.1540-8167.2010.01727.x
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