Safety, obstetric and neonatal data trend of novel arrhythmia management in pregnant: zero-fluoroscopy catheter ablation vs. antiarrhythmic drugs

Abstract Background Zero-fluoroscopy catheter ablation is a novel trend in arrhythmias treatment. However, data of its safety, obstetric and neonatal outcomes in pregnant is limited. Purpose We evaluated clinical characteristics and 24 months outcomes in pregnant with arrhythmias after zero-fluoroscopy catheter ablation. Methods In this single-center, prospectively study 47 pregnant women undergoing zero-fluoroscopy catheter ablation were enrolled (mean age 24.7±2.4 years, mean gestation age 22.9 ±2.9 weeks). Clinical signs, obstetric and neonatal outcomes were compared with pregnant taking antiarrhythmic drugs (control group, n=69, mean age 26.5±1.3 years, mean gestation age 24.2 ±3.6 weeks, p=0.675). Results The clinical, laboratory and echocardiographic characteristics are summarized in table 1. The echocardiographic baseline values were within normal range for all pregnant. There were no statistically significant differences between the two group by prevalent type of arrhythmias and comorbidities. Ablation procedures were performed under guidance of CARTO (n=21; 44.7%) and Ensite Precision systems (n=26; 55.3%) with intracardiac echocardiography without fluoroscopy in all cases. There was no incidence of termination of gestation in both groups. Complication of gestation were comparable, while incidence of uterine contractile activity (4.5%, p=0.464) and placental abruption (2,3%, p=0.414) were only after catheter ablation. Obstetric outcomes characterized by vaginal type of delivery and in-term delivery in the majority (76.6% vs.84%, p=0.242 and 95.7% vs. 96.3%, p=0.623). Neonatal outcomes were also benign without mortality. Fetal birth weight and 5 minute Apgar score were within normal range for all pregnant, both those treated with zero-fluoroscopy catheter ablation and those treated with antiarrhythmic drugs, and there were no statistically significant differences between the two group (3207.4±485 vs. 3312.3±234.1 grams and 8.4±1.6 vs. 8.7±1.2 respectively). During follow-up there were no arrhythmia recurrence after ablation. Conclusions The trend of obstetric and neonatal data shows safety and effectiveness of zero-fluoroscopy catheter ablation of arrhythmias in pregnant.Clinical characteristics