Permanent pacemaker implantation without fluoroscopy in a pregnant woman with complete atrioventricular block: A case report

A 26-year-old pregnant woman in her first trimester presented with progressive fatigue. Her Electrocardiogram showed second degree heart block (Mobitz type II) with intermittent complete heart block. We decided to proceed with dual-chamber permanent pacemaker implantation using CARTO mapping system to avoid fluoroscopy exposure. A mapping catheter was inserted through the right femoral vein. An electro-anatomical map of cardiac chambers was created using the mapping catheter. Through left axillary vein access, the two pacemaker leads were successfully positioned guided by the electro-anatomical map. No complications were noted post procedure. Pacemaker was functioning appropriately at follow-up visits.