Permanent pacemaker implantation without fluoroscopy in a pregnant woman with complete atrioventricular block: A case report

Abstract

A 26-year-old pregnant woman in her first trimester presented with progressive fatigue. Her Electrocardiogram showed second degree heart block (Mobitz type II) with intermittent complete heart block. We decided to proceed with dual-chamber permanent pacemaker implantation using CARTO mapping system to avoid fluoroscopy exposure. A mapping catheter was inserted through the right femoral vein. An electro-anatomical map of cardiac chambers was created using the mapping catheter. Through left axillary vein access, the two pacemaker leads were successfully positioned guided by the electro-anatomical map. No complications were noted post procedure. Pacemaker was functioning appropriately at follow-up visits.

The Utility of Leadless Atrioventricular Synchronous Pacemaker Implantation as a Novel Alternative to a Traditional Pacemaker During Pregnancy

“…Different approaches have been explored in the literature, such as performing 3-dimensional cardiac mapping to aid the implantation of a traditional dual-chamber pacemaker. 4 During the coronavirus disease 2019 (COVID-19) pandemic, leadless pacemakers were shown to be a safer alternative to traditional pacemakers in light of their less-invasive nature, which allows for a shorter procedure time and a reduced mean fluoroscopy time. 5 Here, we report an alternate novel approach to manage a pregnant patient with complete heart block by implanting a leadless pacemaker with minimal fluoroscopy exposure.…”