Outcome of drug resistant severe atrial tachycardia during pregnancy treated with catheter ablation

Abstract

A 24-year-old primigravid woman at 28 weeks of gestation was admitted to the hospital because of drug-refractory atrial tachycardia and heart failure. The arrhythmia did not respond to drug therapy and electrical cardioversion. Since tachycardia was intractable and had potentially life-threatening consequences for mother and fetus, it was decided to ablate the tachycardia after a multidisciplinary meeting. During the procedure, maternal hypotension occurred, consequently causing persistent fetal heart rate reduction. Radiofrequency ablation was immediately cancelled and emergency cesarean section was carried out. At 72 hours after the caesarean-section, successful RF ablation could be performed. Mother was discharged on the 7. postoperative day. The newborn was hospitalized until having reached 2500 g and he was discharged in good condition. Mother's left ventricle systolic function significantly improved and no atrial tachyarrhythmia was observed on the 6th month follow-up visit.