Fluoroless catheter ablation of supraventricular and ventricular arrhythmias in pregnancy: validation of a standard approach in a large multicenter registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Stec ◽  
K Styczkiewicz ◽  
J Sledz ◽  
A Sledz ◽  
M Chrabaszcz ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmia ◽  
Pregnant Women ◽  
Ventricular Arrhythmias ◽  
Study Group ◽  
Heart Team ◽  
Femoral Access ◽  
Electroanatomic Mapping System ◽  
Multicenter Registry ◽  
In Pregnancy

Abstract Background An increasing experience in zero- (ZF) or near-zero fluoroscopy catheter ablation (CA) supports the implementation of early, fluoroless approach for recurrent, symptomatic arrhythmias in pregnancy. Purpose The aim of the study was to evaluate the feasibility, efficacy, and safety of CA with a standardized ZF approach during pregnancy. Methods Data were derived from a large prospective multicenter registry (ELEKTRO-RARE-A-CAREgistry). Between 2012 and 2019, more than 2655 CA procedures were performed in women in intention-to-treat using a ZF fluoroscopy approach. The procedures were performer using: 1) femoral access, 2) double-catheter technique, without intracardiac echocardiography, 3) electroanatomic mapping system (Ensite, Abbott, USA) for mapping and navigation, 4) conscious, light sedation. Shared decision making approach was applied, including a pregnancy heart team consultations. Results The study group consisted of 18 pregnant women (mean age: 30.3±5.0 years; range: 19–38 years; mean gestational age during CA: 21.4±9.2 weeks; range: 7–36 weeks). All pregnant women had no overt structural heart disease. Among women in reproductive age, pregnant women referred for ZF-CA approach accounted for approximately 2% of procedures. In the study group, the major indications for CA included: AVNRT (n=10); OAVRT/WPW (n=2); focal idiopathic ventricular arrhythmia (n=4), AT (n=1) and AF (n=1). Five women had double substrate for CA. In AF case general anesthesia and transesophageal echocardiography were used to monitor ZF-transseptal puncture and right-sided pulmonary vein isolation. All procedures were successfully completed without fluoroscopy, and without serious maternal or fetal complications. The procedure and ablation application times were 55.0±30.0 min and 394±338 s, respectively. In one patient second procedure for idiopathic ventricular arrhythmia was postponed after delivery. Conclusion Implementation of pregnancy heart team and a standard fluoroless protocol for CA in daily electrophysiological practice allowed an early, safe, and effective CA of maternal supraventricular tachycardia and idiopathic ventricular arrhythmias in pregnancy. Funding Acknowledgement Type of funding source: None

scholarly journals Hybrid Catheter-Based and Surgical Techniques for Ablation of Ventricular Arrhythmias

2020 ◽  
Vol 9 (2) ◽  
pp. 97-103
Author(s):  
Fouad Khalil ◽  
Konstantinos Siontis ◽  
Gabor Bagameri ◽  
Ammar M Killu ◽  
◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmia ◽  
Ventricular Arrhythmias ◽  
Surgical Techniques ◽  
Hybrid Technique ◽  
Surgical Ablation ◽  
Safety And Efficacy ◽  
Energy Delivery ◽  
Novel Approach ◽  
Growing Body

Catheter ablation is a rapidly expanding and evolving field. The advent of interventional techniques and advances in technology have allowed catheter ablation to supplant antiarrhythmic surgery for ventricular arrhythmia treatment. However, issues related to access and energy delivery limit the use of catheter ablation in some cases. Hybrid catheter-based and surgical techniques represent a novel approach to overcome these limitations. The hybrid technique combines the strengths and minimises the limitations of either catheter or surgical ablation alone. There is a growing body of evidence in the literature supporting the safety and efficacy of the hybrid surgical technique. This review aims to provide an overview of hybrid surgical-catheter ablation for ventricular arrhythmia.

scholarly journals ROLE OF MATERNAL ERYTHROCYTE ARGINASE ACTIVITY IN PREGNANCY – A PILOT STUDY

2011 ◽  
Vol 01 (01/03) ◽  
pp. 30-32
Author(s):  
Sukanya Shetty ◽  
Ashalatha V. Rao ◽  
Roopa Bhandary
Keyword(s):  
Pregnant Women ◽  
Growth And Development ◽  
Urea Cycle ◽  
Arginase Activity ◽  
Study Group ◽  
Cycle Enzyme ◽  
Complete Set ◽  
Urea Cycle Enzyme ◽  
In Pregnancy

Abstract Introduction Arginase is an urea cycle enzyme which catalyzes the cleavage of L arginine to L- ornithine and urea. It is expressed in liver, erythrocyte, brain, kidney, mammary gland and intestine. The arginase activity detected in nonhepatic tissues that lacka complete set of urea cycle enzymes is thought to provide ornithine, the biosynthetic precursor of proline, an important constituent of collagen, andthe polyamines, which are important for cell proliferation. Aim and objectives In the current study arginase level in maternal erythrocytes were determined to ascertain any possible role in pregnancy. Study design The study group comprised of total 45 subjects including twenty non – pregnant women (mean age 31.0 ± 6.0 years) and twenty five pregnant women (mean age 29.6 ± 6.1 years) of gestational age between 28 – 38 weeks. Results We found a significant increase in the level of maternal erythrocyte arginase (p 0.05) in pregnant women when compared to non – pregnant women. Conclusion Our study suggests that the increased maternal erythrocyte arginase activity may have a role in fetal growth and development.

The International Infections in Pregnancy Study: group B streptococcal colonization in pregnant women

2004 ◽  
Vol 15 (4) ◽  
pp. 267-274 ◽  
Author(s):  
CG Whitney ◽  
S Daly ◽  
S Limpongsanurak ◽  
MR Festin ◽  
KK Thinn ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Study Group ◽  
Group B ◽  
In Pregnancy

scholarly journals The influence of bacterial vaginosis on gestational week of the completion of delivery and biochemical markers of inflammation in the serum

2014 ◽  
Vol 71 (10) ◽  
pp. 931-935 ◽  
Author(s):  
Ana Jakovljevic ◽  
Mirjana Bogavac ◽  
Aleksandra Nikolic ◽  
Mirjana Milosevic-Tosic ◽  
Zoran Novakovic ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Biochemical Markers ◽  
Control Group ◽  
Vaginal Fluid ◽  
Study Group ◽  
Markers Of Inflammation ◽  
Increased Risk ◽  
In Pregnancy

Bacground/Aim. Preterm delivery is one of the most common complications in pregnancy, and it is the major cause (75- 80%) of all neonatal deaths. Bacterial vaginosis predisposes to an increased risk of preterm delivery, premature rupture of membrane and miscarriage. In this syndrome normal vaginal lactobacilli, which produce protective H2O2, are reduced and replaced with anaerobic, gram-negative bacteria and others. The aim of this study was to evaluate the influence of bacterial vaginosis on the week of delivery and biochemical markers of inflammation in the serum. Methods. A total of 186 pregnant women were included into this study, between the week 16 and 19 of pregnancy. In the study group there were 76 pregnant women with diagnosed bacterial vaginosis by the criteria based on vaginal Gram-stain Nugent score and Amsel criteria. In the control group there were 110 healthy women with normal vaginal flora. Ultrasound examination was performed in both groups. Vaginal fluid and blood samples were taken to determine biochemical markers with colorimetric methods. Results. The week of delivery was statistically significantly shorter in the study group and the levels of biochemical markers of inflammation (C-reactive protein and fibrinogen in the serum) were statistically significantly higher in women with bacterial vaginosis comparing to the control group. Also the levels of uric acid and white blood cells in the serum were higher in the study group compared to the control one. Conclusion. Our study indicates that the pregnancy complicated with bacterial vaginosis ends much earlier than the pregnancy without it. Also, higher levels of biochemical markers of inflammation in the serum in the study group, similarly to results of other studies, suggest that pathophysiological processes responsible for preterm delivery can begin very early in pregnancy.

scholarly journals Clinical significance of ultrasonic placental grading during third trimester in hypertensive disorders in pregnancy and its correlation with fetal outcome in tertiary care centre

2021 ◽  
Vol 10 (9) ◽  
pp. 3325
Author(s):  
Aruna Naik ◽  
Susheela Khoiwal ◽  
Nisha Sharma ◽  
Priya Aarthy
Keyword(s):  
Pregnant Women ◽  
Birth Asphyxia ◽  
Morbidity And Mortality ◽  
Study Group ◽  
Perinatal Morbidity ◽  
Foetal Distress ◽  
Third Trimester ◽  
Foetal Outcome ◽  
Grade Iii ◽  
In Pregnancy

Background: Hypertension is one of the common complications in pregnancy and contributes significantly to maternal and perinatal morbidity and mortality. The aim of the present study was to study placental grading by grading by ultrasonography in pregnancy complicated with hypertension and normotensive gravidas. To compare the foetal outcome regarding placental grading and its correlation pattern of placental grade distribution, type of delivery, foetal distress, birth asphyxia, foetal maturity, perinatal morbidity and mortality.Methods: The present study was conducted for a period of 12 months, which included 200 patients who attended OPD at PDRMC, Udaipur. Inclusion criteria was hypertensive pregnant women with BP >140/90 mmHg. Exclusion criteria was Pregnancy associated with other medical disorders, twin gestation, renal and cardiovascular disease and diabetes mellitus.Results: 100 pregnant women with preeclampsia as study group. The most common age group in study group is 22-23 Years. The grade III placenta was found early third trimester in study group. Caesarean delivery was more common mode of delivery in grade III placenta. In foetal outcome small for gestational age was more among the grade III placenta. Foetal distress, birth asphyxia, perinatal mortality, morbidity more among the grade III placenta among the study group.Conclusions: Foetal complications were significantly more in study group compared to control group. Ultrasound placental grade III was statistically significant in correlating with foetal complications like foetal distress, birth asphyxia, perinatal morbidity and mortality. 

scholarly journals The lollipop with lemon aroma may be promising in nausea and vomiting in pregnancy

2019 ◽  
pp. 1
Author(s):  
Ismail Biyik ◽  
Fatih Keskin
Keyword(s):  
Hospital Admission ◽  
Pregnant Women ◽  
Case Control Study ◽  
First Trimester ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Study Group ◽  
Time Of Presentation ◽  
Control Study ◽  
In Pregnancy

<p><strong>OBJECTIVE:</strong> To determine the effect of lemon-flavored lollipop on nausea and vomiting of pregnancy.</p><p><strong>STUDY DESIGN:</strong> This prospective case-control study included 67 first trimester pregnant women. The 12-hour Pregnancy-Unique Quantification of Emesis and Nausea score was calculated at the time of presentation to the hospital. The study group (32 cases) was given lemon-flavored lollipops while the control group (35 cases) did not receive lollipops. The Pregnancy-Unique Quantification of Emesis and Nausea scores of the patients were recalculated on the morning of the post-treatment day. </p><p><strong>RESULTS:</strong> The Pregnancy-Unique Quantification of Emesis and Nausea scores of the study group were higher (p=0.013) than in the control group on the day of admission. Pregnancy-Unique Quantification of Emesis and Nausea scores were similar between the groups on the day after hospital admission (p &gt; 0.005). The Pregnancy-Unique Quantification of Emesis and Nausea difference values obtained by extracting the Pregnancy-Unique Quantification of Emesis and Nausea score on the day after hospital admission from the presentation Pregnancy-Unique Quantification of Emesis and Nausea score were higher in the study group (p=0.0046). Lemon-flavored lollipops were found to decrease nausea and vomiting of pregnancy. </p><p><strong>CONCLUSION:</strong> Lemon-flavored lollipops can be given especially to pregnant women who are concerned about the possible teratogenic effects of drug use in pregnancy. Lemon-flavored lollipops are cheap and easily accessible and therefore promising as a non-pharmacological complementary treatment for nausea and vomiting of pregnancy.</p>

scholarly journals The efficacy and safety of non-fluoroscopic catheter ablation of arrhythmias in pregnancy after mid-long-term follow-up: a single- center experience

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A Abdrakhmanov ◽  
B Ainabekova ◽  
O Nuralinov ◽  
A Bakytzhanuly ◽  
A Smagulova
Keyword(s):  
Catheter Ablation ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Fetal Mortality ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Free Wall ◽  
Efficacy And Safety ◽  
Accessory Pathways ◽  
In Pregnancy

Abstract Funding Acknowledgements Type of funding sources: None. Background Despite the incidence of arrhythmias in pregnancy data on non-fluoroscopic catheter ablation in pregnant women and perinatal outcomes is limited. Purpose the aim of this study is to prospectively assess the efficacy and safety of non-fluoroscopic catheter ablation in pregnant women with arrhythmias. Methods 44 pregnant women (mean age of 28,2 ± 4,2 years, mean gestation age 24,4 ±3,8 weeks) indicated for catheter ablation were enrolled. The ablation was performed under the guidance of CARTO (n = 20; 45%) and Ensite Precision systems (n = 24; 55%) without fluoroscopy. Ablation characteristics, procedure-related complications and clinical outcomes were evaluated during 18 months follow-up. Results all 44 cases of ablation were successful.  There were 14 (31,8%) ablation of accessory pathways - in left free wall (n = 8),  in right free wall (n = 5), posteroseptal (n = 1). 19 patients (43,2%) underwent ablation for atrioventricular nodal reentrant tachycardia. In 3 cases (6,8%) were combination of accessory pathways with slow conduction ways. Ablation of the right ventricular outflow tract was performed in 8 cases (18,2%) of frequent premature ventricular contractions and idiopathic ventricular tachycardia.  The median procedural time was 71 minutes (interquartile range 54-97). Procedural complication was documented in 1 patient (2,3%), who developed an ileofemoral thrombosis. Perinatal outcomes: spontaneus vaginal (n = 35; 79.5%) or vaginal-assisted (n = 4; 9.1%) delivery were in the majority. Five pregnancies (11.4%) were delivered by cesarean section. Mean median gestational age at delivery was 39 ± 1,12 weeks. In one case was placental abruption (2,3%).  Maternal cardiac events was none declared. There were 44 live births (in all pregnancies). Fetal birth weight was 3324,39 ± 625,1 grams, 5 minute Apgar was 8,81 ± 1,9. There were no maternal and fetal mortality. During follow-up there were no arrhythmia recurrence. Conclusions non-fluoroscopic catheter ablation of arrhythmias is feasible and can be safety performed in pregnancy. Our data suggests that these pregnancies were with good perinatal and neonatal outcomes.

TO REVIEW THE TIMING OF INTERVENTION WHICH WILL PROVIDE THE BEST OUTCOME IN HYPOTHYROIDISM IN PREGNANCY

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Archana Mohana ◽  
Dr. Sujata Badoniya
Keyword(s):  
Pregnant Women ◽  
Thyroid Disease ◽  
Fetal Outcome ◽  
Thyroxine Therapy ◽  
In Pregnancy

The Aim of this study is to Review the timing of intervention which will provide the Best Outcome in Hypothyroidism in Pregnancy. Hypothyroid pregnant women are appropriately managed with regular antenatal checkup and thyroxine therapy during pregnancy, a good maternal and fetal outcome can be achieved and congenital cretinism and other neuro developmental sequele in the offspring can be averted. Keywords: Intervention, Hyperthyroidism, Pregnancy & Thyroid disease.

A COMPARATIVE STUDY OF IODINE METABOLISM IN PREGNANCY, SPORADIC GOITRE AND THYROTOXICOSIS

1965 ◽  
Vol 48 (1) ◽  
pp. 14-22 ◽  
Author(s):  
S. A. Aboul-Khair ◽  
J. Crooks
Keyword(s):  
Comparative Study ◽  
Pregnant Women ◽  
Iodine Deficiency ◽  
Physiological Responses ◽  
Iodine Uptake ◽  
Thyroid Activity ◽  
Deficiency State ◽  
Iodine Metabolism ◽  
Inorganic Iodine ◽  
In Pregnancy

ABSTRACT Studies of iodine metabolism have been carried out in 15 pregnant women, 33 cases with sporadic goitre and 11 with thyrotoxicosis. A low plasma inorganic iodine was common to the three groups. In pregnancy and sporadic goitre the thyroid clearance of iodine was elevated and the absolute iodine uptake normal. A high thyroid clearance of iodine in thyrotoxicosis was associated with a high absolute iodine uptake. The results suggest that both pregnancy and sporadic goitre are physiological responses to an iodine deficiency state while the iodine deficiency state of thyrotoxicosis is secondary to increased thyroid activity.

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