title: Catheter ablation of cardiac arrhythmias in pregnancy without fluoroscopy: A case control retrospective study.
abstract: BACKGROUND
  Cardiac arrhythmias are common in pregnant women. In most cases, they do not require treatment other than rest, electrolyte supplementation and avoidance of strong coffee and tea. Persistent arrhythmia or the ventricular rate running at a high frequency may cause hemodynamic deterioration in the fetus or in both the fetus and the mother.
  
  
  OBJECTIVE
  The aim of this study was to assess the prevalence and characteristics of arrhythmias in pregnant women who qualified for ablation as well as the feasibility and specific features of these interventions.
  
  
  METHODS
  The study group consisted of 11 pregnant women (16-32 Hbd) aged 31 + 6. The control group consisted of 111 women aged 15-50 years (34 + 10), scheduled for ablation in 2012. The medical records of the selected study and control groups were analyzed and the following data was retrieved: age, the reason the ablation procedure was performed, the ablation duration, the number of radiofrequency applications, the total duration of radiofrequency applications, gravity, and comorbidities.
  
  
  RESULTS
  In the study group, accessory pathway related arrhythmias or atrial tachycardia (AT) accounted for 62% of cases, whereas in the control group for 32% (p = 0.042). All the procedures in the study group were performed with an electroanatomical system without fluoroscopy. All of the patients, but one, had no recurrence of arrhythmia. There were no complications and no overt effects were noted in the fetus.
  
  
  CONCLUSIONS
  Ablation of arrhythmias during pregnancy is rare. An experienced surgeon using electroanatomical system is usually able to ablate arrhythmic substrate without the use of X-ray fluoroscopy. The most prevalent causes of arrhythmias in pregnant women requiring ablation are accessory pathway and AT focus.
authors.affiliation: 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Edward
authors.initials: E
authors.lastname: Koźluk
authors.affiliation: Chair of Emergency Medicine, Wroclaw Medical University, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Piątkowska
authors.affiliation: Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warszawa, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Kiliszek
authors.affiliation: 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Lodziński
authors.affiliation: 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Małkowska
authors.affiliation: 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Balsam
authors.affiliation: 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Rodkiewicz
authors.affiliation: 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Radosław
authors.initials: R
authors.lastname: Piątkowski
authors.affiliation: Chair of Emergency Medicine, Wroclaw Medical University, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Zyśko
authors.affiliation: 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D016022:Case-Control Studies; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D012189:Retrospective Studies
keywords: ablation; cardiac arrhythmias; safety