title: Catheter ablation of supraventricular tachycardia without fluoroscopy during pregnancy.
abstract: BACKGROUND
  Although uncommon, supraventricular tachycardia is difficult to manage during pregnancy. Catheter ablation traditionally has been deferred owing to radiation exposure risks. Three-dimensional mapping is a new tool in cardiac electrophysiology, which is being utilized to eliminate fluoroscopy during catheter ablation. We report a case of ablation of supraventricular tachycardia during pregnancy without using fluoroscopy.
  
  
  METHODS
  A 27-year-old woman with a 22-week twin gestation was referred for incessant supraventricular tachycardia. Medical management with propranolol and flecainide was unsuccessful. An electrophysiology study was performed with catheter navigation guided by a three-dimensional mapping system instead of fluoroscopy. The patient underwent successful cryoablation. The procedure was performed without fluoroscopy or sedation. The patient delivered healthy twins at 35 weeks of gestation without complications. On follow-up at 26 months, she showed no evidence of recurrence.
  
  
  CONCLUSIONS
  New tools in electrophysiology now make curative procedures more readily available to pregnant women and safer for the fetus.
authors.affiliation: Department of Cardiology, The Heart Center, and the Department of Pediatrics, Maternal-Fetal Medicine, Akron Children's Hospital, Akron, Ohio, and the Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Amee M
authors.initials: AM
authors.lastname: Bigelow
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Crane
authors.forename: Fadi R
authors.initials: FR
authors.lastname: Khoury
authors.forename: John M
authors.initials: JM
authors.lastname: Clark
mesh_terms: D000328:Adult; D017115:Catheter Ablation; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D013617:Tachycardia, Supraventricular / Q000601:surgery*