Document Detail

Catheter ablation of supraventricular tachycardia without fluoroscopy during pregnancy.
MedLine Citation:
PMID:  24770194     Owner:  NLM     Status:  In-Data-Review    
INTRODUCTION: Supraventricular tachycardia is relatively uncommon in pregnancy. Symptomatic arrhythmias create challenges in management during pregnancy. Catheter ablation, the usual curative treatment of choice for supraventricular tachycardia, is often deferred as a result of risks of radiation exposure to the developing fetus. Three-dimensional mapping is a new tool in cardiac electrophysiology, which is being used to eliminate fluoroscopy during catheter ablation. We report a case of successful ablation of supraventricular tachycardia during pregnancy without the use of fluoroscopy.
METHODS: A 27-year-old previously healthy woman with a 22-week monozygotic twin gestation was referred for palpitations. Her initial 12-lead electrocardiogram showed supraventricular tachycardia at 185 beats per minute. An echocardiogram showed normal function with a left ventricular ejection fraction of 57%. A 24-hour Holter monitor recorded supraventricular tachycardia 50% of the time. Initial medical management with propranolol and flecainide was unsuccessful.
RESULTS: An electrophysiology study was performed from the right femoral vein with catheter navigation guided by EnSite instead of fluoroscopy. This confirmed an atrioventricular nodal reentrant tachycardia, which was successfully cryoablated. The procedure was performed without fluoroscopy or sedation. There were no complications. The twins delivered at 35 weeks of gestation by cesarean. At 15 months follow-up, there has been no recurrence of supraventricular tachycardia and both twins are doing well.
CONCLUSION: New tools in electrophysiology now make curative ablation procedures more readily available to pregnant women and safer for the fetus.
John M Clark; Amee M Bigelow; Stephen S Crane; Fadi R Khoury
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  123 Suppl 1     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-04-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  44S-5S     Citation Subset:  AIM; IM    
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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