Non-fluoroscopic radiofrequency ablation using electro-anatomic mapping is a feasible and effective treatment for drug-resistant incessant atrial tachycardia during pregnancy.
Supports feasibility of zero-fluoroscopy ablation in pregnancy; hypothesis-generating and requires prospective validation before broader adoption.
We describe a patient presenting with incessant ectopic atrial tachycardia during a high risk twin pregnancy. Tachycardia was resistant to escalating doses of beta-blockade with digoxin. Because of increasing left ventricular dysfunction early in the third trimester, catheter ablation was performed successfully at 30 weeks gestation. Electro-anatomic mapping permitted the entire procedure to be conducted without the use of ionizing radiation. The pregnancy proceeded to successful delivery near term and after three years the patient remains recurrence free with normal left ventricular function, off all medication.
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Zuberi et al. (2014) studied this question.
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