Abstract: Objective To investigate the efficacy and safety of catheter ablation without fluoroscopy in pregnancy with tachyarrhythmia.-Methods- From January 2016 to January 2020, 31 pregnancies with tachycardia were treated by radiofrequency ablation in Beijing Anzhen Hospital, Capital Medical University. The efficacy and safety of radiofrequency ablation were analyzed, and the differences in efficacy and prognosis were compared with those at different stage of pregnancy.Results ①A total of 31 patients were treated with 0 ray under the three-dimensional electromagnetic navigation mapping system. 27 patients were cured (87.1%), 3 patients were improved (9.7%), 1 patient was ineffective (3.2%), and 1 patient relapsed (3.7%). Cardiac function was improved significantly after treatment (P=0.000). ② There was no recurrence of arrhythmia in 31 cases during and after delivery. ③ There were 1 case of spontaneous abortion, 1 case of premature delivery, 29 cases of full-term delivery. The average gestational age was (38.3±1.4) weeks, 21 cases of full-term cesarean section, and 8 cases of vaginal delivery. There was no significant difference in pregnancy outcome after different pregnancy treatments(P=0.107). The average weight of the newborn was (3280±489)g. The Apgar score of the fifth minutes was 10. There was no small for gestational age infant and no neonatal asphyxia death. No abnormal growth and development was found during the follow-up of 1-5 years. There was no significant difference in fetal outcomes after different pregnancy treatments(P=0.527). Conclusion Catheter ablation without fluoroscopy guided by three-dimensional electromagnetic catheter mapping system has good compliance, high cure rate, low recurrence rate and good prognosis of mother and infant. It is a safe and effective way to treat drug intolerant sustained tachyarrhythmia.There was no significant difference in the prognosis of the operation in the middle or late trimester. For patients who were cured after operation and had good cardiac function, vaginal delivery could be performed after multidisciplinary evaluation without contraindications.

Key words: tachyarrhythmia, gestation, catheter ablation without fluoroscopy