Rescue- ablation of electrical storm in arrhythmogenic right ventricular cardiomyopathy in pregnancyReport as inadecuate




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BMC Cardiovascular Disorders

, 13:58

Non-coronary artery cardiac disease

Abstract

BackgroundRadiofrequency ablation RFCA became a treatment of choice in patients with recurrent ventricular tachycardia, ventricular fibrillation, and appropriate interventions of implanted cardioverter-defibrillator ICD, however, electrical storm ES ablation in a pregnant woman has not yet been reported.

Case presentationWe describe a case of a successful rescue ablation of recurrent ES in a 26-year-old Caucasian woman during her first pregnancy 23rd week. The arrhythmogenic right ventricular dysplasia-cardiomyopathy ARVD-C was diagnosed 3 years earlier and several drugs as well as 2 ablations failed to control recurrences of ventricular tachycardia. RFCA was performed on the day of the third electric storm. The use of electroanatomic mapping allowed very low X-ray exposure, and after applications in the right ventricular outflow tract, arrhythmia disappeared. Three months after ablation, a healthy girl was delivered without any complications. During twelve-month follow-up there was no recurrence of ventricular tachycardia or ICD interventions.

ConclusionsThis case documents the first successful RFCA during ES due to recurrent unstable ventricular arrhythmias in a patient with ARVD-C in pregnancy. Current guidelines recommend metoprolol, sotalol and intravenous amiodarone for prevention of recurrent ventricular tachycardia in pregnancy, however, RFCA should be considered as a therapeutic option in selected cases. The use of 3D navigating system and near zero X-ray approach is associated with minimal radiation exposure for mother and fetus as well as low risk of procedural complication.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2261-13-58 contains supplementary material, which is available to authorized users.

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Author: Sebastian Stec - Tomasz Krynski - Jakub Baran - Piotr Kulakowski

Source: https://link.springer.com/article/10.1186/1471-2261-13-58







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