Key result
Zero x-rays radiofrequency catheter ablation successfully eliminated ventricular premature contractions originating from the left coronary cusp in a pregnant woman.
Why the study?
RFA during pregnancy should preferably avoid x-rays, but ablation of ventricular arrhythmias originating from the left coronary cusp is particularly challenging due to proximity to the left main coronary artery.
Does zero x-rays radiofrequency catheter ablation eliminate ventricular premature contractions originating from the left coronary cusp in a pregnant woman?
Case Report (n=1)
No
Does zero x-rays radiofrequency catheter ablation eliminate ventricular premature contractions originating from the left coronary cusp in a pregnant woman?
Zero x-rays radiofrequency catheter ablation guided by 3D mapping is a safe and effective strategy for treating severe ventricular premature contractions originating from the left coronary cusp during pregnancy.
Alerts clinicians to arrhythmia risks in pregnancy; case report extends sparse literature but leaves optimal strategies open.
Pregnancy predisposes to arrhythmias in females due to physiological changes in the cardiovascular system, enhanced activity of the sympathetic nervous system (SNS), and changes in the endocrine system, regardless of whether there exist cardiovascular diseases before the pregnancy. Tachyarrhythmias may present for the first time or worsen persistently during pregnancy, potentially leading to maternal heart failure and sudden death, as well as some adverse fetal outcomes such as growth restriction, distress, premature birth, and stillbirth. Radiofrequency ablation (RFA) is one of the most important therapeutic methods for tachyarrhythmias. According to the 2019 European Society of Cardiology (ESC) guidelines, RFA in pregnant women should preferably be performed without x-rays. Since the 2000s, 3D mapping technique has rapidly developed, laying the foundation for cardiac electrophysiology examination free from x-rays. Ventricular arrhythmia originating from the left coronary cusp (LCC) is not common in clinic. RFA is challenging in the treatment of this type of disease due to the anatomical feature that the opening of the left main coronary artery is localized in the LCC.
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Li et al. (2023) conducted a case report in Ventricular premature contraction originating from the left coronary cusp (n=1). Zero x-rays radiofrequency catheter ablation was evaluated on Elimination of ventricular premature contractions. Zero x-rays radiofrequency catheter ablation successfully eliminated ventricular premature contractions originating from the left coronary cusp in a pregnant woman.
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