Maternal and Fetal Outcomes in Zero Fluoroscopy Symptomatic PVC Ablation

Premature ventricular complex (PVC) constitutes the most prevalent arrhythmia in pregnancy. Because of the potentially adverse maternal and fetal outcomes, managing symptomatic high-burden PVC in pregnancy is challenging; thus, selecting the optimal treatment is crucial. Conventionally, PVC has been managed with beta blockers. However, beta blockers may have negative consequences on the developing fetus. PVC ablation can be performed in patients without fluoroscopy using three-dimensional electroanatomical technology. We present a clinical case series of 6 high-burden pregnant patients who underwent single catheter PVC ablation with zero fluoroscopy during the second trimester of pregnancy. The right ventricular outflow tract was the site of origin of the PVC, which was effectively ablated. All patients were able to continue the pregnancy and delivered at full term. Managing pregnant patients with high-burden PVC is challenging as this population is underrepresented in clinical trials. This case series details the successful management of PVC in pregnancy.