{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T13:00:00Z","timestamp":1789822800016,"version":"4.0.1"},"reference-count":12,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Background: Arrhythmias in pregnancy are complex to manage due to the teratogenic effects of many antiarrhythmic drugs and the common use of ionizing radiation during catheter ablation procedures. Furthermore, pregnant women are extremely vulnerable and difficult to treat because of the progressive physical and hormonal changes that occur during the nine months of pregnancy. Case Presentation: In this case report, we describe a complex clinical case of a 34-year-old pregnant woman who was affected by an incessant right atrial tachycardia, with signs and symptoms of initial hemodynamic instability. This tachycardia was refractory to antiarrhythmic drugs, so a zero-fluoroscopy ablation was performed. The first procedure was complicated by cardiac tamponade, quickly resolved without further complications for the mother or the fetus. In the following days, a deep venous thrombosis occurred at the femoral venous access. After a few days, the patient underwent a second procedure that was successful and resulted in the restoration of a sinus rhythm. Conclusions: The management of this clinical case was complex both from a procedural and a clinical (cardiological and gynecological) point of view. Finally, the integration of the various skills led to an excellent result.<\/jats:p>","DOI":"10.3390\/clinpract14030075","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T11:03:47Z","timestamp":1716375827000},"page":"946-953","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Zero-Fluoroscopy Catheter Ablation of Right Appendage Focal Atrial Tachycardia in a Pregnant Woman"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4133-2664","authenticated-orcid":false,"given":"Federica","family":"Troisi","sequence":"first","affiliation":[{"name":"Department of Cardiology, General Regional Hospital \u201cF. Miulli\u201d, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi","family":"Valenti","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Regional Hospital \u201cF. Miulli\u201d, Acquaviva delle Fonti, 70021 Bari, Italy"},{"name":"Department of Cardiology, A.U.O. Policlinico \u201cGaspare Rodolico\u201d, 95100 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Quadrini","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Regional Hospital \u201cF. Miulli\u201d, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Vitulano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Regional Hospital \u201cF. Miulli\u201d, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-2056","authenticated-orcid":false,"given":"Antonio","family":"Di Monaco","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Regional Hospital \u201cF. Miulli\u201d, Acquaviva delle Fonti, 70021 Bari, Italy"},{"name":"Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imma","family":"Romanazzi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Regional Hospital \u201cF. Miulli\u201d, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Caruso","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Regional Hospital \u201cF. Miulli\u201d, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Orfino","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Regional Hospital \u201cF. Miulli\u201d, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9347-8884","authenticated-orcid":false,"given":"Massimo","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Regional Hospital \u201cF. Miulli\u201d, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3165","DOI":"10.1093\/eurheartj\/ehy340","article-title":"2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy: The Task Force for the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC)","volume":"39","author":"Bauersachs","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jacep.2021.10.004","article-title":"Arrhythmias in Pregnancy","volume":"8","author":"Tamirisa","year":"2022","journal-title":"Clin. Electrophysiol."},{"key":"ref_3","first-page":"206","article-title":"Catheter ablation for tachyarrhythmias during pregnancy","volume":"18","author":"Yuan","year":"2022","journal-title":"Adv. Interv. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1136\/heartjnl-2021-320451","article-title":"Supraventricular arrhythmia in pregnancy","volume":"108","author":"Ramlakhan","year":"2022","journal-title":"Heart"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1111\/jce.12675","article-title":"Catheter Ablation of Arrhythmia during Pregnancy","volume":"26","author":"Driver","year":"2015","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"804424","DOI":"10.3389\/fcvm.2022.804424","article-title":"Zero Fluoroscopy Arrhythmias Catheter Ablation: A Trend toward More Frequent Practice in a High-Volume Center","volume":"9","author":"Troisi","year":"2022","journal-title":"Front. Cardiovasc. 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Pract."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"990325","DOI":"10.3389\/fcvm.2022.990325","article-title":"Case report: Efficacy analysis of radiofrequency catheter ablation pk with atrial appendage resection for atrial tachycardia originating from the atrial appendage in children","volume":"9","author":"Liu","year":"2022","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Bai, Y., Qiu, J., Hu, M., and Chen, G. (2023). Emergent Zero-Fluoroscopy Mapping and Thoracoscopic Ectomy of Appendage in Pregnant Women with Life-Threatening Atrial Tachycardia: A Case Report and Literature Review. Medicina, 59.","DOI":"10.3390\/medicina59030528"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"817","DOI":"10.2217\/fca-2021-0002","article-title":"Biosense Webster\u2019s QDOT Micro\u2122 radiofrequency ablation catheter","volume":"17","author":"Wielandts","year":"2021","journal-title":"Future Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1076029620939181","DOI":"10.1177\/1076029620939181","article-title":"Position Paper on the Management of Pregnancy-Associated Superficial Venous Thrombosis. Balkan Working Group for Prevention and Treatment of Venous Thromboembolism","volume":"28","author":"Antic","year":"2022","journal-title":"Clin. Appl. Thromb. Hemost."}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-7283\/14\/3\/75\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:45:59Z","timestamp":1760107559000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/14\/3\/75"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,21]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["clinpract14030075"],"URL":"https:\/\/doi.org\/10.3390\/clinpract14030075","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,21]]}}}