Case series of catheter-based arrhythmia ablation in pregnant women

Abstract Funding Acknowledgements Type of funding sources: None. Background Antiarrhythmic drugs (AADs) should be used with caution in treating arrhythmias during pregnancy because side effects, but catheter ablation is a rarely procedure. Aim To investigate the efficacy and safety cardiac pregnancy. Methods A double-center retrospective case series study was performed. We studied population patients undergoing for between April 2014 September 2021 two cardiovascular centers Hungary. Results 14 procedures [14 electrophysiology studies (EPS), 13 ablations] performed on gravid women (age 30.3±5.2 years, primipara n=6) were studied. The mean gestation period 24.0 (20.0-27.0) weeks at time intervention, duration arrhythmia 44.0±53.0 months. Of pregnant 38.5% had comorbidities 15.4% structural heart disease. During EPS, 12 inducible arrhythmias. Focal atrial tachycardia confirmed 3, AVRT via manifest accessory pathway (AP) 3 (WPW syndrome) counceled AP 1 case. AVNRT sustained ventricular 2 cases (25-25-8.3-25-16.6%). 11 radiofrequency ablations (RFA) (84.6%) cryoablations (15.4%) electroanatomical mapping system CARTO NavX-EnSite (15.4%). Intracardiac echocardiography (ICE) 5 (38.5%). Transseptal puncture due to left lateral AP. average procedure 76.0±33.0 min. All (100.0%) without fluoroscopy. No complications occurred procedures. In long term, arrhythmia-free survival achieved all (100.0%), patients, we AADs achieve freedom arrhythmia. With AADs, birth weight lower than that fetuses gravidas not taking (2110±1314 vs. 3253±458 g). APGAR within normal range [9.0/10.0 (IQR) (9.0-10.0/9.3-10.0)]. Conclusions Zero-fluoroscopic an effective safe treatment method when needed. Catheter persistent maternal has more beneficial effect fetal development use AADs. Indeed, long-term outcome need investigated larger patient population.