Radiofrequency catheter ablation of supraventricular tachycardia in pregnancy: Ablation without fluoroscopic exposure

Omaygenç, Mehmet Onur; Karaca, İbrahim; Güler, Ekrem; Kızılırmak, Filiz; Çakal, Beytullah; Güneş, Hacı Murat; Kılıçaslan, Fethi

doi:10.1016/j.hrthm.2015.01.037

Cited by 14 publications

(26 citation statements)

References 28 publications

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“…Eight published studies that reported 12 separate pregnant patients undergoing catheter ablation were identified. [ 4 16 17 18 19 20 21 22 ] The studies had 3 patients with atrial tachycardia, 3 patients with atrioventricular nodal reentry tachycardia (AVNRT), 4 patients with AVRT, and 2 patients with persistent junctional reciprocating tachycardia. The mean maternal age was 29 years old (range: 20–48), and catheter ablation was performed at a mean gestational age of 23.4 weeks (range: 10–33).…”

Section: Resultsmentioning

confidence: 99%

“… [18] In order to avoid aortocaval compression by the gravid uterus, the mother should be lying in the left lateral tilt position rather than the supine position. [22] Frequent episodes may lead to a progressive deterioration in ventricular contractile function or a sudden reduction in cardiac output. Therefore, rapid pacing in tachycardia during the procedure should be minimized to avoid deleterious effects on fetal well-being.…”

Section: Discussionmentioning

confidence: 99%

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Zero-fluoroscopy catheter ablation of severe drug-resistant arrhythmia guided by Ensite NavX system during pregnancy

Chen

Sun

et al. 2016

Medicine

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Background:Cardiac arrhythmias can occur during pregnancy. Owing to radiation exposure and other uncertain risks for the mother and fetus, catheter ablation has rarely been performed and is often delayed until the postpartum period. We reported 2 pregnant women who were experiencing severe arrhythmias and were successfully ablated without fluoroscopic guidance. We also carried out a literature review of cases of pregnant women who underwent zero-fluoroscopy ablation.Methods and Results:One woman had drug-resistant and poorly tolerated frequent premature ventricular contraction (PVC) and ventricular tachycardia (VT). The other one had persistent and hardly terminated supraventricular tachycardia (SVT) via a right accessory pathway. The 2 patients were successfully underwent zero-fluoroscopy ablation guided by Ensite NavX system. The procedure time was 42 and 71 minutes, respectively.Conclusion:Catheter ablation of SVT or PVC/VT in pregnant patients can be safely and effectively performed with a completely zero-fluoroscopy approach guided by the Ensite NavX system. In the case of a drug refractory, life-threatening arrhythmia during pregnancy, catheter ablation may be considered.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Zero-fluoroscopy catheter ablation of severe drug-resistant arrhythmia guided by Ensite NavX system during pregnancy

Chen

Sun

et al. 2016

Medicine

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“…Procedural times were consistent with previous reports on nonpregnant patients undergoing the same procedure. [58][59][60][61][62][63][64][65][66][67][68] The ablation of ventricular arrhythmias in two pregnant patients, one with idiopathic right ventricular outflow-tract (RVOT) VPC and the other with VT (RVOT anterior) due to electrical storm in ARVC, were also successfully performed with the use of three-dimensional EAM.…”

Section: State Of Fluoroless Procedures For Special Populationsmentioning

confidence: 99%

State of Fluoroless Procedures in Cardiac Electrophysiology Practice

Canpolat

Faggioni

Rocca

et al. 2020

J Innov Cardiac Rhythm Manage

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In the past decade, the use of interventional electrophysiological (EP) procedures for the diagnosis and treatment of cardiac arrhythmias has exponentially increased. These procedures usually require fluoroscopy to guide the advancement and frequent repositioning of intracardiac catheters, resulting in both the patient and the operator being subjected to a considerable degree of radiation exposure. Although shielding options such as lead gowns, glasses, and pull-down shields are useful for protecting the operator, they do not lessen the patient's level of exposure. Furthermore, the prolonged use of lead gowns can exponentiate the onset of orthopedic problems among operators. Recent advancements in three-dimensional cardiac mapping systems and the use of radiation-free imaging technologies such as magnetic resonance imaging and intracardiac ultrasound allow operators to perform EP procedures with minimal or even no fluoroscopy. In this review, we sought to describe the state of fluoroless procedures in EP practice.

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“…The use of electroanatomical mapping systems has the potential to improve the outcome and reproducibility of AVNRT ablation and to extend indications among populations where fluoroscopy is discouraged, such as in young adults and children, and even during pregnancy. 34,35 The biological risks related to X-ray exposure represent a limit for catheter ablation, especially among children and young adults, and the mapping systems help in obtaining a more precise anatomical reconstruction, particularly in children. Another advantage conferred by the mapping system is the 3D reconstruction of cardiac chambers and vessels, which can be of particular value for patients with congenital heart disease or vascular anomalies, 33,36,37 in whom this benefit can be even greater after merging the reconstruction with imaging techniques such as magnetic resonance or computed tomography.…”

Section: Future Perspectivesmentioning

confidence: 99%

<p>Atrioventricular Nodal Reentrant Tachycardia: Current Perspectives</p>

Matta¹,

Devecchi²,

Vecchi³

et al. 2020

RRCC

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Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common, highly symptomatic paroxysmal supraventricular tachycardia. Despite pharmacological treatment and vagal maneuvers for acute termination, catheter ablation has emerged as the first line treatment for the cure of AVNRT episodes. Several studies during recent years have investigated the efficacy, safety and long-term effect of both radiofrequency ablation and cryoablation of the slow pathway for the treatment of AVNRT. Innovations such as mapping systems and dedicated catheters have contributed by extending the indication to AVNRT ablation, even in particular subset populations such as children and congenital heart disease patients. We performed this review with the aim aim of summarizing and discussing current perspectives on the treatment of AVNRT, mainly focusing on catheter ablation energy sources and long-term results.

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Radiofrequency catheter ablation of supraventricular tachycardia in pregnancy: Ablation without fluoroscopic exposure

Cited by 14 publications

References 28 publications

Zero-fluoroscopy catheter ablation of severe drug-resistant arrhythmia guided by Ensite NavX system during pregnancy

Zero-fluoroscopy catheter ablation of severe drug-resistant arrhythmia guided by Ensite NavX system during pregnancy

State of Fluoroless Procedures in Cardiac Electrophysiology Practice

<p>Atrioventricular Nodal Reentrant Tachycardia: Current Perspectives</p>

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