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Challenge of managing opposing rhythms in a mother and fetus
Author(s) -
ChaudhryWaterman Nadia,
Kumar Vineet,
Karr Sharon,
Fitzpatrick Andrew,
Cohen Mitchell I.
Publication year - 2021
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.14059
Subject(s) - medicine , atrioventricular block , fetus , transplacental , supraventricular tachycardia , cardiology , fetal echocardiography , fluoroscopy , heart block , heart disease , tachycardia , gestation , pregnancy , electrocardiography , prenatal diagnosis , surgery , genetics , placenta , biology
Abstract Introduction We report a case of a fetus with complex congenital heart disease and supraventricular tachycardia in the setting of maternal high grade atrioventricular block at 26 weeks’ gestation. Methods and results Electroanatomic mapping allowed successful implantation of a permanent pacemaker to provide adequate back‐up pacing in the mother with zero radiation exposure, thus allowing safe delivery of transplacental anti‐arrhythmic medications to reduce the fetal arrhythmia burden and optimize the fetal ventricular rate. Conclusion This is the first reported case of using electroanatomic mapping, with zero fluoroscopy use, for pacemaker lead placement and for a novel indication.