WPW syndrome during pregnancy: Increased incidence of supraventricular arrhythmias (original) (raw)
Cardiac arrhythmias in pregnancy: clinical and therapeutic considerations
International Journal of Cardiology, 2003
Pregnancy can precipitate cardiac arrhythmias not previously present in seemingly well individuals. Risk of arrhythmias is relatively higher during labor and delivery. Potential factors that can promote arrhythmias in pregnancy and during labor and delivery include the direct cardiac electrophysiological effects of hormones, changes in autonomic tone, hemodynamic perturbations, hypokalemia of pregnancy, and underlying heart disease. Paroxysmal supraventricular and ventricular tachycardia may cause hemodynamic compromise with consequences to the fetus. Management of arrhythmias in pregnant women is similar to that in non-pregnant but a special consideration must be given to avoid adverse fetal effects. No drug therapy is usually needed for the management of supraventricular or ventricular premature beats, but potential stimulants, such as smoking, caffeine, and alcohol should be eliminated. In paroxysmal supraventricular tachycardia, vagal stimulation maneuvers should be tried first. Adenosine or a cardioselective beta-blocker could be used if vagal maneuvers are ineffective. Alternatively, verapamil or diltiazem may be given. In pregnant women with atrial fibrillation, the goal of treatment is conversion to sinus rhythm or to control ventricular rate by a cardioselective beta-adrenergic blocker drug or digoxin. Ventricular arrhythmias may occur in the pregnant women with cardiomyopathy, congenital heart disease, valvular heart disease, or mitral valve prolapse. Termination of ventricular arrhythmias can usually be achieved by intravenous lidocaine or procainamide or by electrical cardioversion. Amiodarone is not safe for the fetus. Beta-blocker therapy must be continued during pregnancy and postpartum period in women with long QT syndrome and torsade de pointes.
Postpartum cardiogenic shock in a patient with permanent junctional re-entry tachycardia
International Journal of Cardiology, 2011
Permanent junctional reciprocating tachycardia (PJRT) is a rare form of supraventricular arrhythmia, most often encountered in children and adolescents, characterized by antegrade conduction over the atrio-ventricular node and retrograde conduction over a decremental accessory pathway . In the majority of the patients the clinical scenario is dominated by frequent episodes of palpitations, often triggered by exercise. In about 20-30% of cases PJRT may become incessant and lead to advanced left ventricular systolic dysfunction, that is generally reversible after restoration of stable sinus rhythm . However, cardiogenic shock caused by PJRT has never been reported.
Successful electrical cardioversion of supraventricular tachycardia in a pregnant patient
American Journal of Case Reports, 2012
Pregnancy can precipitate cardiac arrhythmias not previously present in seemingly well individuals. Atrial and ventricular premature beats are frequently present during pregnancy and are usually benign. Supraventricular tachycardia and malignant ventricular tachyarrhythmias occur less frequently. Maternal and fetal arrhythmias occurring during pregnancy may jeopardize the life of the mother and the fetus.
Revista Colombiana De Anestesiologia, 2009
This case dealt with a 20-year-old patient in her 31 st week of pregnancy, suffering her first episode of precordial pain, palpitations and syncope. There was no other pertinent personal background. Electrocardiogram revealed paroxysmal supraventricular tachycardia (PSVT). Información para obtener y reproducir los documentos publicados View publication stats View publication stats
Supraventricular arrhythmia in pregnancy
Heart, 2022
The physiological changes during pregnancy predispose a woman for the development of new-onset or recurrent arrhythmia. Supraventricular arrhythmia is the most common form of arrhythmia during pregnancy and, although often benign in nature, can be concerning. We describe three complex cases of supraventricular arrhythmia during pregnancy and review the currently available literature on the subject. In pregnancies complicated by arrhythmia, a plan for follow-up and both maternal and fetal monitoring during pregnancy, delivery and post partum should be made in a multidisciplinary team. Diagnostic modalities should be used as in non-pregnant women if there is an indication. All antiarrhythmic drugs cross the placenta, but when necessary, medical treatment should be used with consideration to the fetus and the mother’s altered pharmacodynamics and kinetics. Electrical cardioversion is safe during pregnancy, and electrophysiological study and catheter ablation can be performed in selecte...
Managing palpitations and arrhythmias during pregnancy
Postgraduate Medical Journal, 2008
A rrhythmias in pregnancy are common and may cause concern for the wellbeing of both the mother and the fetus. For some mothers the arrhythmias may be a recurrence of a previously diagnosed arrhythmia or the first presentation in a woman with known structural heart disease. In most cases, however, there is no previous history of heart disease, and the new occurrence of a cardiac problem can generate considerable anxiety. The majority of arrhythmias that occur during pregnancy are benign, and simply troublesome; hence, advice about appropriate actions during symptomatic episodes, together with reassurance, is usually all that is required. In the remaining minority of cases, judicious use of antiarrhythmic drugs will lead to a safe and successful outcome for both mother and baby. While there were no documented maternal deaths from primary arrhythmias in the last UK confidential enquiry into maternal mortality, 1 9% of cardiac deaths were defined as sudden adult death syndrome, which raises the possibility of death from a primary arrhythmia. In women with known structural heart disease, however, arrhythmia is one of the five independent predictors of having a cardiac event during the pregnancy and should therefore be treated seriously.
Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2017
Pregnancy may predispose to paroxysmal supraventricular tachycardia (SVT), in subjects with or without identifiable heart disease. Many physiological conditions such as autonomic nervous system changes, altered systemic hemodynamics, etc. can contribute to the onset of arrhythmias during pregnancy. Some cases reported the occurrence of arrhythmias in relation to systemic fluid variations. We report the case of a pregnant woman who experienced SVT due to fluid depletion, detected by bioimpedance vector analysis (BIVA), which was successfully treated by water repletion under tight BIVA monitoring. Emergency physicians can overcome dangerous drug administration by considering historical examination and using fast and reproducible techniques such as BIVA.
New-onset ventricular tachycardia during pregnancy
American Heart Journal, 1992
A previously healthy young woman who developed the new onset of symptomatic sustained ventricular tachycardia during pregnancy is described. Evaluation revealed mitral valve prolapse with minimal mitral regurgitation, and normal left ventricular size and function. The arrhythmia resolved after delivery, but recurred nine months later in a nonsustained form. Electrophysiologic study revealed only nonsustained ventricular tachycardia, and she was treated with propafenone. It is suggested that the pregnant state may have been important in the pathogenesis of her arrhythmia.
Paroxysmal Supraventricular Tachycardia: A Complex Dilemma during Pregnancy
Journal of South Asian Federation of Obstetrics and Gynaecology, 2015
The acute and chronic management of paroxysmal supraventricular tachycardia (PSVT) during pregnancy presents a challenging clinical situation as there are no evidence-based guidelines despite being the commonest arrhythmia found in pregnancy. We report a case of paroxysmal supraventricular tachycardia in a 25 years old antenatal woman with no organic heart disease, where she received verapamil followed by diltiazem as antiarrhythmics instead of adenosine for conversion into sinus rhythm. Since she had recurrent episodes in third trimester she received verapamil and metoprolol as prophylaxis with good fetal and maternal outcome. This case highlights the need to understand the complexities in diagnosis and management of paroxysmal supraventricular tachycardia during pregnancy.