Safety of Zero-Fluoroscopic Catheter Ablation During Pregnancy

Abstract

Incidence of all types of arrhythmias is higher during pregnancy, clinically significant tachyarrhythmias are rare. Since maternal tachyarrhythmias could cause hemodynamic compromise with adverse fetal complications, early recognition and effective treatment is warranted. Catheter ablation (CA) is widely regarded as the most effective treatment option for various tachyarrhythmias; however, possible procedural complications and radiation exposure that may cause harm to the mother and the fetus resulted in a hesitation to perform CA during pregnancy. Recent advances in non-fluoroscopic catheter navigation have helped minimize the radiation exposure during ablation. Although available published evidence on the safety profile and efficacy of CA without the use of fluoroscopy in comparison with anti-arrhythmic drug (AAD) therapy during pregnancy is very limited, it could lower the threshold to perform ablation in pregnant women that are not responsive to AAD therapy. Fluoroless CA could especially be utilized in pregnant patients with uncontrolled tachycardia causing hemodynamic compromise with fetal distress and in tachycardia-induced cardiomyopathy.