Implantation of a permanent pacemaker in a pregnant woman under the guidance of electrophysiologic signals and transthoracic echocardiography

Pedrinazzi, Claudio; Gazzaniga, Pietro; Durin, Ornella; Tovena, Daniela Maria; Inama, Giuseppe

doi:10.2459/jcm.0b013e3283100edc

Cited by 10 publications

(4 citation statements)

References 8 publications

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“…Echocardiography can be useful with the aid of electrocardiographic signals; however, reliable visualization of the leads during navigation in the veins and the heart is not possible with an echocardiogram. Pedrinazzi et al [8] described a case of pacemaker implantation in a pregnant woman with sinus node dysfunction with the help of a hybrid technique There are some reports where NFMS was used to utilize and facilitate pacemaker implantation in pregnant patients. Small case series have described the use of NavX for single-lead ventricular permanent pacemakers with an acceptable accuracy rate and without a significant increase in procedural or fluoroscopic time [9][10][11].…”

Section: Discussionmentioning

confidence: 97%

Cardiac Interventions in Pregnant Patients without Fluoroscopy

et al. 2015

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Section: Discussionmentioning

confidence: 97%

Cardiac Interventions in Pregnant Patients without Fluoroscopy

et al. 2015

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“…The only available studies reporting successful CIEDs implantation using 3D‐EAM among pregnant patients were in case report designs. 39 , 40 , 41 , 42 , 43 , 44 , 45 Therefore, further studies should aim to address the limitations of our meta‐analysis and systematic review by including a more diverse range of study populations to confirm the feasibility and safety of the ZMF approach for CIEDs implantation, especially among pregnant patients.…”

Section: Discussionmentioning

confidence: 99%

Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis

Luke,

Milla,

Tandi

et al. 2023

Journal of Arrhythmia

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BackgroundFluoroscopy is conventionally performed for cardiac implantable electronic device (CIED) therapy and carries radiation drawback for both patients and medical workers. Recently, zero to minimal fluoroscopy (ZMF) approach is introduced to reduce radiation exposure of fluoroscopy. This study compares the feasibility and safety of ZMF approach to fluoroscopy for CIEDs therapy in adults.MethodA systematic literature search was conducted on PubMed, ScienceDirect, and Web of Science in March 2023. All observational or experimental studies comparing ZMF approach to fluoroscopy for adult CIEDs therapy were included. Reviews, case report/series, animal studies, and non‐English articles were excluded. The success rate, procedural time, fluoroscopy time, radiation dose, and complications rate were compared for each approach.ResultsSeven articles for permanent and three articles for temporary CIEDs were included for analysis. The success rate of ZMF for permanent CIEDs was similar to fluoroscopy method (OR: 0.77, 95% CI: 0.33–4.15). The procedural time of ZMF was similar to fluoroscopy for both permanent and temporary CIEDs (standardized mean difference [SMD]: 0.10, 95% CI: −0.35 to 0.55 and SMD: −0.71, 95% CI: −1.87–0.44, respectively). However, ZMF approach markedly reduced the fluoroscopy time and radiation exposure for permanent CIEDs (SMD: −1.80, 95% CI: −2.49 to −1.12 and SMD: −1.26, 95% CI: −2.24 to −0.29). The complication rate was similar for permanent CIEDs (OR: 1.08, 95% CI: 0.41–2.84), yet lowered for temporary CIEDs (OR: 0.34, 95% CI: 0.20–0.59).ConclusionZMF had similar success rate, procedural time, and sum complication rate for permanent CIEDs implantation with a significant reduction of fluoroscopy time and radiation exposure.

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“…On the contrary, the teratogenic properties of fluoroscopy, routinely used during PM implantation, should not be underestimated. Either a protective shield covering the gravid uterus or a fluoroscopy-free approach using electrophysiologic signals and ECHO guidance for pacemaker insertion should be used [ 29 , 30 ]. Moreover, another modern fluoroscopy-free possibility is to use a cardiac mapping system during the PM implantation procedure [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Management of Complete Heart Block in a Pregnant Woman with Systemic Lupus Erythematosus-Associated Complications: Treatment Considerations and Pitfalls

et al. 2022

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We present a case of a pregnant woman with systemic lupus erythematosus (SLE) who was diagnosed with asymptomatic complete heart block (CHB) during pregnancy. To evaluate possible risks and benefits of pacemaker (PM) implantation, a multidisciplinary counselling board was held. Its recommendation was to perform PM implantation to prevent intra-uterine growth restriction from insufficient cardiac output using a fluoroscopic protective shield. The procedure was performed without complications and established permanent pacing on onwards ECG examinations. The patient subsequently gave birth to a healthy newborn. After a retrospective clinical case evaluation and review of relevant literature, a presumptive association between CHB and the primary diagnosis was proposed. Above that, pregnant women with SLE who develop hypertension are commonly treated with methyldopa, which may cause conduction abnormalities. Clinical recommendations for young female patients expecting pregnancy are lacking in this area. Careful diagnostic and treatment approaches should be used in the management of possible SLE-related complications in women of child-bearing age, focusing on preventable events.

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Implantation of a permanent pacemaker in a pregnant woman under the guidance of electrophysiologic signals and transthoracic echocardiography

Cited by 10 publications

References 8 publications

Cardiac Interventions in Pregnant Patients without Fluoroscopy

Cardiac Interventions in Pregnant Patients without Fluoroscopy

Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis

Management of Complete Heart Block in a Pregnant Woman with Systemic Lupus Erythematosus-Associated Complications: Treatment Considerations and Pitfalls

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