Arrhythmias and Pregnancy

Williams, Dominique; Mikhova, Krasimira; Sodhi, Sandeep

doi:10.1016/j.ccl.2020.09.013

Cited by 10 publications

(21 citation statements)

References 48 publications

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“…Although the ESC guideline still states that this is the treatment of choice for maternal arrhythmias 4 . Procainamide, adenosine, digoxin, CCB, and BB are considered safe to use during pregnancy (IC recommendation), although they may have undesirable side effects (e.g., low birth weight) 6–8 . Williams et al 8 examined in detail the effects of each group of AADs on the fetus.…”

Section: Discussionmentioning

confidence: 99%

“…In our patient population, catheter ablation was a reliable, effective, and safe choice for pregnant patients with zero fluoroscopy. Williams et al 8 claims that catheter ablation is performed safely during pregnancy. However, it should be performed in carefully selected patients with clinically significant drug‐refractory tachyarrhythmias with adverse effects on the mother and fetus 13 .…”

Section: Discussionmentioning

confidence: 99%

“…The larger studies on ablation treatment of arrhythmias in pregnancy have only examined maternal outcomes 17 . Williams et al 8 investigated the effects of AAD on the fetus and birth weight but did not examine the long‐term development of the children.…”

Section: Discussionmentioning

confidence: 99%

“…3 Untreated maternal arrhythmias can adversely affect fetal development or, if treated with AAD, cause lower birth weight and other complications. 6,8,17 Catheter ablation is considered safe in pregnant patients in a carefully selected patient population, 8,13 but current guidelines recommend it only for symptomatic and drugrefractory maternal arrhythmias. 5 The results of our study suggest that zero-fluoroscopic ablation has several advantages over longterm antiarrhythmic drug therapy and can be performed safely with a high success rate among a well-selected population of pregnant women.…”

Section: Limitationsmentioning

confidence: 99%

“…Procainamide, adenosine, digoxin, CCB, and BB are considered safe to use during pregnancy (IC recommendation), although they may have undesirable side effects (e.g., low birth weight) [6][7][8]. Williams et al8 examined in detail the effects of each group of AADs on the fetus. They found that BBs are known to reduce birth weight.…”

mentioning

confidence: 99%

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Case series of catheter‐based arrhythmia ablation in 13 pregnant women

Mladoniczky

Nagy

Földesi

et al. 2023

Clinical Cardiology

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BackgroundCatheter ablation is a rarely used procedure to treat arrhythmias during pregnancy.HypothesisIn the case of maternal arrhythmia during pregnancy, zero‐fluoroscopic catheter ablation is preferable to medical treatment.MethodsBetween April 2014 and September 2021, we examined the demographic data, procedural parameters, and fetal and maternal outcomes in pregnant women undergoing ablation at the Gottsegen National Cardiovascular Center and University of Pécs Medical School, Heart Institute.ResultsFourteen procedures (14 electrophysiological studies [EPS], 13 ablations) performed on 13 pregnant women (age 30.3 ± 5.2 years, primipara n = 6) were studied. During EPS, 12 patients had inducible arrhythmias. Atrial tachycardia was confirmed in three, atrioventricular re‐entry tachycardia via manifest accessory pathway (AP) in three, and via concealed AP in one case. Atrioventricular nodal re‐entry tachycardia was confirmed in three and sustained monomorphic ventricular tachycardia in two cases. Eleven radiofrequency ablation (84.6%) and two cryoablation (15.4%) were performed. The electroanatomical mapping system was used in all cases. Transseptal puncture was performed in two cases (15.4%) due to left lateral APs. The mean procedure time was 76.0±33.0 minutes. All procedures were performed without fluoroscopy. No complications occurred. During the follow‐up, arrhythmia‐free survival was achieved in all cases, but in two patients, we used antiarrhythmic drugs (AADs) to achieve it. APGAR score was within the normal range in all cases [median (interquartile range), 9.0/10.0 (9.0–10.0/9.3–10.0)].ConclusionsZero‐fluoroscopic catheter ablation was an effective and safe treatment option for our 13 pregnant patients. Catheter ablation may have less side effects on fetal development than the use of AADs during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%