Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 1, January-February, p. 129–134

doi: 10.17219/acem/68275

Publication type: original article

Language: English

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Catheter ablation of cardiac arrhythmias in pregnancy without fluoroscopy: A case control retrospective study

Edward Koźluk1,A,B,C,D,E,F, Agnieszka Piątkowska2,A,B,E,F, Marek Kiliszek3,A,B,E,F, Piotr Lodziński1,A,E,F, Sylwia Małkowska1,A,B,E,F, Paweł Balsam1,A,B,E,F, Dariusz Rodkiewicz1,A,B,E,F, Radosław Piątkowski1,A,B,E,F, Dorota Zyśko2,A,B,C,D,E,F, Grzegorz Opolski1,A,B,E,F

1 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland

2 Chair of Emergency Medicine, Wroclaw Medical University, Poland

3 Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warszawa, Poland

Abstract

Background. Cardiac arrhythmias are common in pregnant women. In most cases, they do not require treatment other than rest, electrolyte supplementation and avoidance of strong coffee and tea. Persistent arrhythmia or the ventricular rate running at a high frequency may cause hemodynamic deterioration in the fetus or in both the fetus and the mother.
Objectives. The aim of this study was to assess the prevalence and characteristics of arrhythmias in pregnant women who qualified for ablation as well as the feasibility and specific features of these interventions.
Material and Methods. The study group consisted of 11 pregnant women (16–32 Hbd) aged 31 + 6. The control group consisted of 111 women aged 15–50 years (34 + 10), scheduled for ablation in 2012. The medical records of the selected study and control groups were analyzed and the following data was retrieved: age, the reason the ablation procedure was performed, the ablation duration, the number of radiofrequency applications, the total duration of radiofrequency applications, gravity, and comorbidities.
Results. In the study group, accessory pathway related arrhythmias or atrial tachycardia (AT) accounted for 62% of cases, whereas in the control group for 32% (p = 0.042). All the procedures in the study group were performed with an electroanatomical system without fluoroscopy. All of the patients, but one, had no recurrence of arrhythmia. There were no complications and no overt effects were noted in the fetus.
Conclusion. Ablation of arrhythmias during pregnancy is rare. An experienced surgeon using electroanatomical system is usually able to ablate arrhythmic substrate without the use of X-ray fluoroscopy. The most prevalent causes of arrhythmias in pregnant women requiring ablation are accessory pathway and AT focus.

Key words

safety, ablation, cardiac arrhythmias

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