Preview

Siberian Journal of Clinical and Experimental Medicine

Advanced search

THE COMPLEXITY OF THE TREATMENT OF CARDIAC ARRHYTHMIAS IN PREGNANT WOMEN. CASE OF RADIOFREQUENCY ABLATION OF ATRIAL TACHYCARDIA IN A PREGNANT WOMAN USING A THREE-DIMENSIONAL NONFLUOROSCOPIC NAVIGATION SYSTEM

https://doi.org/10.29001/2073-8552-2019-34-2-106-112

Abstract

Purpose. Pregnant women, due to physiological changes in the body, are more prone to cardiac arrhythmias, the frequency of which ranges from 5 to 18%. Paroxysmal supraventricular tachycardia (SVT) occurs in 14% of pregnant women with cardiac arrhythmias. In the treatment of cardiac arrhythmias, radiofrequency ablation (RFA) is currently preferred over antiarrhythmic drugs. However, RFA is associated with radiation exposure to the mother and fetus. The current level of development of arrhythmology provides a unique opportunity to eliminate cardiac arrhythmias without the use of fluoroscopic technologies, which completely excludes radiation exposure.

Clinical case. The article presents a clinical case of a 17-year-old patient diagnosed with idiopathic paroxysmal atrial tachycardia successfully treated in Cardiology Research Institute, Tomsk NRMC. When admitted to the hospital, the patient was at 31 weeks of pregnancy.

Conclusion. The described case shows the possibility and necessity of using non-fluoroscopic navigation systems when performing RFA in pregnant women. RFA using electroanatomic mapping allows to remove the burden of receiving antiarrhythmic therapy in pregnant women without the use of X-ray.

About the Authors

M. A. Kirgizova
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

M.D., Cand. Sci. (Med.), Junior Research Scientist, Department of Interventional Arrhythmology

111a, Kievskaya str., Tomsk, 634012, Russian Federation



A. A. Dedkova
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

M.D., Cand. Sci. (Med.), Cardiologist, Department of Interventional Arrhythmology

111a, Kievskaya str., Tomsk, 634012, Russian Federation



I. V. Kisteneva
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

M.D., Cand. Sci. (Med.), Cardiologist, Department of Interventional Arrhythmology

111a, Kievskaya str., Tomsk, 634012, Russian Federation



S. N. Krivolapov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

M.D., Doctor for Endovascular Diagnosis and Treatment. Department of Interventional Arrhythmology

111a, Kievskaya str., Tomsk, 634012, Russian Federation



References

1. Stryuk R.I., Bunin Yu.A., Gureva V.N., Irtyuga O.B., Kokov L.S., Kolomatskaya O.E., et al. Diagnostics and treatment of cardiovascular diseases in pregnancy. National clinical guidelines 2018. Rossijskij kardiologicheskij zhurnal=Russian Journal of Cardiology. 2018;3(155):91–134 (In Russ.). DOI: 10.15829/1560-4071-2018-3-91-134.

2. Regitz-Zagrosek V., Blomstrom Lundqvist C., Borghi C., Cifkova R., Ferreira R., Foidart J.M., et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the task force on the management of cardiovascular diseases during pregnancy of the European Society of Cardiology (ESC). Eur. Heart J. 2011 Dec.;32:3147–3197. DOI: 10.1093/eurheartj/ehr218.

3. Mangusheva M.M., Rudneva T.V., Yakupova S.P., Shamsutdinova N.G., Shameeva L.S. Violation of the rhythm of the heart and conduction in pregnant women. Clinical observation. Prakticheskaya medicina=Practical Medicine. 2013;69(1–2):7–13 (In Russ.).

4. MacIntyre C., Iwuala C., Parkash R. Cardiac arrhythmias and pregnancy. Current Treatment Options in Cardiovascular Medicine. 2018 Jul. 11;20(8):63. DOI: 10.1007/s11936-018-0660-9.

5. Dedkova A.A., Kirgizova M.A., Kisteneva I.V., Borisova E.V. Six years of experience in managing pregnant women with heart rhythm and conduction disturbances. Materials of the All-Russian scientific and educational forum “Cardiology of the XXI century: alliances and potential”. Tomsk; 2018 Apr. 25-27:107–110 (In Russ.).

6. Canobbio M.M., Warnes C.A., Aboulhosn J., Connolly H.M. Management of pregnancy in patients with complex congenital heart disease: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2017;135(8):e50–e87. DOI: 10.1161/CIR.0000000000000458.

7. Ermakova E.A., Matyushin G.V., Gogolashvili N.G., Eremina N.P. The frequency of arrhythmias and cardiac conduction in women in the third trimester of pregnancy. Sibirskoe medicinskoe obozrenie=Siberian Medical Review. 2013;1:49–52 (In Russ.).

8. Mogutova P.A., Poteshkina N.G. Cardiac arrhythmias in pregnant women. Rossijskij medicinskij zhurnal. Mat’ i ditya=Russian Medical Journal. Mother and Child. 2016;5:331–333 (In Russ.).

9. Stryuk R.I., Berns S.A., Fhilippova M.P., Brytkova I.V., Borisov I.V., Barkova E.L. et al. Cardiovascular diseases and associated comorbid conditions as factors determining unfavorable perinatal outcomes in pregnancy — analysis of the data from the register of pregnant women BEREG. Therapevticheskiy Arkhiv=Therapeutic Archive. 2018;1(90):9–16 (In Russ.). DOI: 10.17116/terarkh20189019-16.

10. Runikhina N.K., Vasilyeva A.V., Novikova I.M., Tkachyova O.N. Cardiac arrhythmias in pregnant women with connective tissue dysplasia. Akusherstvo i ginekologiya=Obstetrics and Gynecology. 2012;3:97–102 (In Russ.).

11. Bernal O., Moro C. Cardiac arrhythmias in women. Rev. Esp. Cardiol. 2006;59:609–618.

12. Yarnoz M.J., Curtis A.B. More reasons why men and women are not the same (gender differences in electrophysiology and arrhythmias). Am. J. Cardiol. 2008;101:1291–1296.

13. Astakhova A.V., Lepakhin V.K. Drugs. Adverse adverse reactions and safety monitoring. Series: Professional medicine. M.: Eksmo; 2008:256 (In Russ.).

14. Kosenko V.V., Glagolev S.V. The organization of the system of monitoring the safety of medicines registered in the Russian Federation. Vestnik Roszdravnadzora. 2011;6:31–39 (In Russ.).

15. Sanitary rules and regulations 2.6.1.1192-03 «Hygienic requirements for the device and operation of x-ray rooms, devices and X-ray examinations » (approved by the Chief state sanitary doctor of the Russian Federation on February 14, 2003) (In Russ.).

16. Sidorova I.S. Physiology and pathology of labor. A guide for practicing physicians. Moscow: Medical news Agency; 2013:1048 (In Russ.).


Review

For citations:


Kirgizova M.A., Dedkova A.A., Kisteneva I.V., Krivolapov S.N. THE COMPLEXITY OF THE TREATMENT OF CARDIAC ARRHYTHMIAS IN PREGNANT WOMEN. CASE OF RADIOFREQUENCY ABLATION OF ATRIAL TACHYCARDIA IN A PREGNANT WOMAN USING A THREE-DIMENSIONAL NONFLUOROSCOPIC NAVIGATION SYSTEM. Siberian Journal of Clinical and Experimental Medicine. 2019;34(2):106-112. (In Russ.) https://doi.org/10.29001/2073-8552-2019-34-2-106-112

Views: 2179


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2713-2927 (Print)
ISSN 2713-265X (Online)