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孕期在Ensite NavX系统引导下对严重耐药性心律失常进行零荧光透视导管消融:两例病例报告及文献综述

Zero-fluoroscopy catheter ablation of severe drug-resistant arrhythmia guided by Ensite NavX system during pregnancy: Two case reports and literature review.

作者信息

Chen Guangzhi, Sun Ge, Xu Renfan, Chen Xiaomei, Yang Li, Bai Yang, Yang Shanshan, Guo Ping, Zhang Yan, Zhao Chunxia, Wang Dao Wen, Wang Yan

机构信息

Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.

出版信息

Medicine (Baltimore). 2016 Aug;95(32):e4487. doi: 10.1097/MD.0000000000004487.

Abstract

BACKGROUND

Cardiac arrhythmias can occur during pregnancy. Owing to radiation exposure and other uncertain risks for the mother and fetus, catheter ablation has rarely been performed and is often delayed until the postpartum period. We reported 2 pregnant women who were experiencing severe arrhythmias and were successfully ablated without fluoroscopic guidance. We also carried out a literature review of cases of pregnant women who underwent zero-fluoroscopy ablation.

METHODS AND RESULTS

One woman had drug-resistant and poorly tolerated frequent premature ventricular contraction (PVC) and ventricular tachycardia (VT). The other one had persistent and hardly terminated supraventricular tachycardia (SVT) via a right accessory pathway. The 2 patients were successfully underwent zero-fluoroscopy ablation guided by Ensite NavX system. The procedure time was 42 and 71 minutes, respectively.

CONCLUSION

Catheter ablation of SVT or PVC/VT in pregnant patients can be safely and effectively performed with a completely zero-fluoroscopy approach guided by the Ensite NavX system. In the case of a drug refractory, life-threatening arrhythmia during pregnancy, catheter ablation may be considered.

摘要

背景

孕期可发生心律失常。由于存在辐射暴露以及对母亲和胎儿的其他不确定风险,导管消融术很少进行,且常推迟至产后。我们报告了2例患有严重心律失常的孕妇,她们在无透视引导下成功接受了消融治疗。我们还对接受零透视消融的孕妇病例进行了文献综述。

方法与结果

1例女性患有耐药且耐受性差的频发室性早搏(PVC)和室性心动过速(VT)。另1例通过右侧旁路患有持续性且难以终止的室上性心动过速(SVT)。这2例患者在Ensite NavX系统引导下成功接受了零透视消融。手术时间分别为42分钟和71分钟。

结论

在Ensite NavX系统引导下采用完全零透视方法,可安全有效地对孕妇进行SVT或PVC/VT的导管消融。对于孕期药物难治性、危及生命的心律失常,可考虑导管消融。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a427/4985319/8461cb6bef55/medi-95-e4487-g002.jpg

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