ArticleFrontiers in cardiovascular medicine2026
Zero-fluoroscopy catheter ablation for arrhythmias in pregnancy: validation of a standardized approach with 5-year follow-up.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Increasing experience with zero- (ZF) or near-zero fluoroscopy catheter ablation (CA) supports the implementation of an early fluoroless approach for recurrent, symptomatic arrhythmias during pregnancy. Aim: This study evaluated the feasibility, efficacy, and safety of CA using a standardized ZF approach during pregnancy. Methods: Data were derived from a large, prospective multicenter registry (ELEKTRO-RARE-A-CAREgistry). Between 2012 and 2019, more than 2,655 CA procedures were performed in women using an intention-to-treat ZF approach. The procedures were performed using (1) femoral access, (2) a double-catheter technique without intracardiac echocardiography, (3) an electroanatomic mapping system for mapping and navigation, and (4) conscious light sedation. A shared decision-making approach was applied, including consultation with a pregnancy heart team. Results: The study group consisted of 18 consecutive pregnant women without structural heart disease (mean age: 30.6 ± 4.7 years; range: 20-38 years). The mean gestational age at the time of CA was 20.2 ± 9.5 weeks (range: 7-37 weeks), representing <0.01% of all female patients referred for CA. During 18 index procedures, a total of 21 arrhythmogenic substrates were ablated. The major indications for CA during pregnancy were atrioventricular nodal reentrant tachycardia ( Conclusions: The implementation of a pregnancy heart team and a standardized fluoroless protocol for CA in routine electrophysiological practice enables safe and effective ablation of maternal supraventricular tachycardia and idiopathic ventricular arrhythmias during pregnancy.
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