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https://hdl.handle.net/2440/62013
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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 1540-8167 |
Statement of Responsibility: | 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 fluoroscopy pregnancy supraventricular tachycardia Wolff-Parkinson-White syndrome |
Rights: | © 2010 Wiley Periodicals, Inc. |
DOI: | 10.1111/j.1540-8167.2010.01727.x |
Published version: | http://dx.doi.org/10.1111/j.1540-8167.2010.01727.x |
Appears in Collections: | Aurora harvest 5 Medicine publications |
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