scholarly journals Successful Ablation of Ventricular Arrhythmia Without Fluoroscopy Guided by Carto 3 System in Pregnant Woman Without Structural Heart Disease

2020 ◽  
Vol 8 (2) ◽  
pp. 236-238
Author(s):  
Ayan Abdrakhmanov ◽  
Aliya Smagulova ◽  
Bayan Ainabekova
Keyword(s):  
Heart Disease ◽  
Pregnant Woman ◽  
Catheter Ablation ◽  
Pregnant Women ◽  
Electrophysiological Study ◽  
Harmful Effect ◽  
Structural Heart Disease ◽  
Interventional Treatment ◽  
Navigation Systems ◽  
Premature Ventricular Contractions

Introduction: Arrhythmias can take place in any period of pregnancy. In addition, the incidence of life-threatening ventricular arrhythmias in a pregnant woman without the organic pathology of the heart is rare. Interventional treatment should be carried out in cases of severe arrhythmias and drug resistance. The radiation exposure during ablation carries a potentially harmful effect on the mother and fetus although data on the zero-fluoroscopy ablation of arrhythmias in pregnant women is limited. Case Presentation: A 26-year-old female without structural heart disease at the gestation period of 26-28 weeks was admitted to a hospital due to severe symptoms of ventricular tachycardia (VT) and premature ventricular contractions. In this regard, the conservative therapy of β-blockers was ineffective and accompanied by a decrease in blood pressure to 60/40 mm Hg. Results: An intracardiac electrophysiological study and non-fluoroscopic catheter ablation were carried out considering the drug refractory and severe symptoms of VT. The ablation of the arrhythmia substrate was successfully performed using the Carto 3 System without fluoroscopy. Based on the results, the procedure was not associated with any maternal or fetal complications. Conclusions: In general, the non-fluoroscopic catheter ablation guided by electro-anatomical mapping and navigation systems is safe and applicable in the treatment of pregnant women with severe types of arrhythmias.

Sustained monomorphic ventricular tachycardia: the role of catheter ablation

ESC CardioMed ◽  
2018 ◽  
pp. 2279-2288
Author(s):  
Tilman Maurer ◽  
William G. Stevenson ◽  
Karl-Heinz Kuck
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Therapeutic Option ◽  
Structural Heart Disease ◽  
Premature Ventricular Contractions ◽  
Monomorphic Ventricular Tachycardia ◽  
Premature Beats

Monomorphic ventricular tachycardia (VT) may occur in the presence or absence of structural heart disease. The standard therapy for patients with structural heart disease at high risk of sudden cardiac death due to VT is the implantable cardioverter defibrillator (ICD). While ICDs effectively terminate VT and prevent sudden cardiac death, they do not prevent recurrent episodes of VT, since the underlying arrhythmogenic substrate remains unchanged. However, shocks from an ICD increase mortality and impair quality of life. These limitations as well as continuous advancements in technology have made catheter ablation an important treatment strategy for patients with structural heart disease presenting with VT. Idiopathic ventricular arrhythmias include premature ventricular contractions and VT occurring in the absence of overt structural heart disease. In this setting, catheter ablation has evolved as the primary therapeutic option for symptomatic ventricular premature beats and sustained VTs and is curative in most cases. This chapter presents an overview of the principles of invasive diagnosis and treatment of monomorphic VTs in patients with and without structural heart disease and delineates the clinical outcome of catheter ablation. Finally, the chapter provides an outlook to the future, discussing potential directions and upcoming developments in the field of catheter ablation of monomorphic VT.

scholarly journals Catheter ablation of ventricular arrhythmias and in-hospital mortality: insights from the German-wide Helios hospital network of 5052 cases

EP Europace ◽  
2019 ◽  
Author(s):  
Sebastian König ◽  
Laura Ueberham ◽  
René Müller-Röthing ◽  
Michael Wiedemann ◽  
Michael Ulbrich ◽  
...  
Keyword(s):  
Heart Disease ◽  
Catheter Ablation ◽  
Hospital Mortality ◽  
Ventricular Arrhythmias ◽  
Emergency Admission ◽  
Structural Heart Disease ◽  
Mortality Rates ◽  
Hospital Death ◽  
Premature Ventricular Contractions ◽  
Hospital Transfer

Abstract Aims Catheter ablation (CA) of ventricular arrhythmias is one of the most challenging electrophysiological interventions with an increasing use over the last years. Several benefits must be weighed against the risk of potentially life-threatening complications which necessitates a steady reevaluation of safety endpoints. Therefore, the aims of this study were (i) to investigate overall in-hospital mortality in patients undergoing such procedures and (ii) to identify variables associated with in-hospital mortality in a German-wide hospital network. Methods and results Between January 2010 and September 2018, administrative data provided by 85 Helios hospitals were screened for patients with main or secondary discharge diagnosis of ventricular tachycardia (VT) or premature ventricular contractions (PVCs) in combination with an arrhythmia-related CA using ICD- and OPS codes. In 5052 cases (mean age 60.9 ± 14.3 years, 30.1% female) of 30 different hospitals, in-hospital mortality was 1.27% with a higher mortality in patients ablated for VT (1.99%, n = 2, 955) compared to PVC (0.24%, n = 2, 097, P < 0.01). Mortality rates were 2.06% in patients with ischaemic heart disease (IHD, n = 2, 137), 1.47% in patients with non-ischaemic structural heart disease (NIHD, n = 1, 224), and 0.12% in patients without structural heart disease (NSHD, n = 1, 691). Considering different types of hospital admission, mortality rates were 0.35% after elective (n = 2, 825), 1.60% after emergency admission/hospital transfer <24 h (n = 1, 314) and 3.72% following delayed hospital transfer >24 h after initial admission (n = 861, P < 0.01 vs. elective admission and emergency admission/hospital transfer <24 h). In multivariable analysis, a delayed hospital transfer >24 h [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.59–3.28, P < 0.01], the occurrence of procedure-related major adverse events (OR 6.81, 95% CI 2.90–16.0, P < 0.01), Charlson Comorbidity Index (CCI, OR 2.39, 95% CI 1.56–3.66, P < 0.01) and its components congestive heart failure (OR 8.04, 95% CI 1.71–37.8, P < 0.01), and diabetes mellitus (OR 1.59, 95% CI 1.13–2.22, P < 0.01) were significantly associated with in-hospital death. Conclusions We reported in-hospital mortality rates after CA of ventricular arrhythmias in the largest multicentre, administrative dataset in Germany which can be implemented in quality management programs. Aside from comorbidities, a delayed hospital transfer to a CA performing centre is associated with an increased in-hospital mortality. This deserves further studies to determine the optimal management strategy.

scholarly journals Supine Frequent Ventricular Extrasystoles in a Pregnant Woman without Structural Heart Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Natália Stela Sandes Ferreira ◽  
Tatiana La Croix Barros ◽  
Ronaldo Altenburg Gismondi
Keyword(s):  
Heart Disease ◽  
Pregnant Woman ◽  
Pregnant Women ◽  
Primary Care Physicians ◽  
Venous Return ◽  
Vena Cava ◽  
Structural Heart Disease ◽  
Ventricular Extrasystoles ◽  
Ventricular Premature Complexes ◽  
The Right

Arrhythmias are the most common cardiac complication during gestational period and may occur in women with or without known structural heart disease. Premature extra beats and sustained tachyarrhythmias are the most common arrhythmias in pregnancy. Symptomatic episodes occur in 20–44% of pregnant women, usually as palpitations, dizziness, or syncope. We searched on Pubmed for ventricular premature complexes (VPC) in pregnant women and found no case reporting increased incidence of this arrhythmia while supine. The aim of this study is to report a case of a pregnant woman without previous structural heart disease that presented a great number of VPC when supine. The arrhythmogenesis increase during pregnancy is multifactorial. In the reported case, we believe that augmented venous return was the most important pathophysiologic process. When the patient changes to left lateral decubitus, there could be a sudden release of the inferior vena cava, causing an abrupt augmentation of venous return to the right heart chambers and increasing the risk of arrhythmias. Obstetricians and primary care physicians should be aware of palpitations and related patient complains while they are asleep or supine.

scholarly journals Are premature ventricular contractions in patients without apparent structural heart disease really safe?

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Charles Jazra ◽  
Oussma Wazni ◽  
Wael Jaroudi
Keyword(s):  
Heart Disease ◽  
Catheter Ablation ◽  
Beta Blockers ◽  
Structural Heart Disease ◽  
Arrhythmogenic Right Ventricular Dysplasia ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Channel Blockers ◽  
Premature Ventricular Contractions ◽  
Lv Dysfunction

<p>Premature ventricular complexes (PVC) are considered benign when they occur in patients without apparent structural heart disease. They usually originate from the right, or less commonly, left ventricular outflow tract. Their suppression was not beneficial in patients with heart disease like myocardial infarction and cardiomyopathies. Recently it has been shown that their suppression medically or by ablation, improved the left ventricular (LV) dysfunction. This led to the hypothesis that they may contribute to this LV dysfunction especially when they are particularly frequent (&gt; 20000 per day). Because of some overlap with arrhythmogenic right ventricular dysplasia, the evaluation in patients without apparent heart disease should consider an magnetic resonance imaging if the echocardiography was not able to help in diagnosis especially when there is a suspicion.</p><p>Patients without structural heart disease and low-to modest PVC burdens do not always require treatment.</p><p>When necessary, treatment for PVCs involves beta-blockers, calcium channel blockers, or other antiarrhythmic</p><p>drugs and catheter ablation in selected cases. Catheter ablation can be curative, but it is typically reserved</p><p>for drug-intolerant or medically refractory patients with a high PVC burden.</p>

scholarly journals Use of Routine Echocardiographic Screening for Structural Heart Disease in At-Risk Pregnant Women in India

2020 ◽  
Author(s):  
Amisha Patel ◽  
Lauren S. Ranard ◽  
Nicole Aranoff ◽  
Hussein Rahim ◽  
Roja Vanukuru ◽  
...  
Keyword(s):  
At Risk ◽  
Heart Disease ◽  
Pregnant Women ◽  
Structural Heart Disease ◽  
Women In India
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