Recurrent unsustained ventricular tachycardia in pregnancy

Česká verzia

Authors: K. Prymusová; O. Ludka; V. Musil; J. Špinar
Authors place of work: Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MU Dr. Jindřich Špinar, CSc., FESC
Published in the journal: Vnitř Lék 2009; 55(11): 1097-1101
Category: Case Reports

Summary

The incidence of arrhythmias in pregnancy is more frequent. Arrhythmias can develop in women with structural heart disease as well as in healthy population. Palpitations, dizziness, vertigo or syncope are the most common symptoms of arrhythmias. Rarely life threatening arrhythmias requiring acute therapy occur. The treatment of the pregnant patient with cardiac arrhythmias requires important modifications of the standard practice. We describe pregnant patient in 33rd week of pregnancy with new onset of recurrent unsustained ventricular tachycardia, which did not regress after the pharmacological therapy. Patient was indicated to cesarean section, after which the arrhythmias completely regressed.

Key words:
arrhythmias – pregnancy

Zdroje

1. Tan HL, Lie KI. Treatment of tachyarrhythmias during pregnancy and lactation. Eur Heart J 2001; 22: 458– 464.

2. Hameed A, Karaalp IS, Tummala PP et al. The effect of valvular heart disease on maternal and fetal outcome of pregnancy. J Am Coll Cardiol 2001; 37: 893– 899.

3. Brodsky M, Doria R, Allen B et al. New- onset ventricular tachycardia during pregnancy. Am Heart J 1992; 123: 933– 941.

4. Shotan A, Ostrzega E, Mehra A et al. Incidence of arrhythmias in normal pregnancy and relation to palpitations, dizziness and syncope. Am J Cardiol 1997; 79: 1061– 1064.

5. Lee SH, Chen SA, Wu TJ et al. Effect of pregnancy on first onset and symptoms of paroxysmal supraventricular tachycardia. Am J Cardiol 1995; 76: 675– 678.

6. Nakagawa M, Katou S, Ichinose M et al. Characteristics of new‑onset ventricular arrhythmias in pregnancy. J Electrocardiol 2004; 37: 47– 53.

7. Lydakis C, Lip G, Beevers M et al. Atenolol and fetal growth in pregnancy complicated by hypertension. Am J Hypertens 1999; 12: 541– 547.

8. Frishman W, Chesner M. Beta‑adrenergic blockers in pregnancy. Am Heart J 1988; 115: 147– 152.

9. Chan V, Tse T, Wong V. Transfer of digoxin across 23 the placenta and into breast milk. Br J Obstet Gynaecol 1978; 85: 605– 609.

10. Kautzner J, Bytešník J, Čihák R. Arytmie. In: Aschermann M et al (eds). Kardiologie. Praha: Galén 2007: 1126– 1146.

11. Belhassen B, Shapira I, Pelleg A et al. Idiopathic recurrent sustained ventricular tachycardia responsive to verapamil: an ECG- electrophysiologic entity. Am Heart J 1984; 108: 1034– 1037.

12. Page RL, Shenasa H, Evans JJ et al. Radiofrequency catheter ablation of idiopathic recurrent ventricular tachycardia with right- bundle branch block, left axis morphology. Pacing Clin Electrophysiol 1993; 16: 327– 336.

13. Roden DM, Lazzara R, Rosen M et al. Multiple mechanisms in the long QT syndrome: current knowledge, gaps and future directions. Circulation 1996; 94: 1996– 2012.

14. Finlay AY, Edmunds V. DC cardioversion in pregnancy. Br J Clin Pract 1979; 33: 88– 94.

15. Joglar JA, Page RL. Antiarrhythmic drugs in pregnancy. Curr Opin Cardiol 2001; 16: 40– 45.

16. Cardosi RJ, Chez RA. Magnesium sulfate, maternal hypothermia and fetal bradycardia with loss of heart rate variability. Obstet Gynecol 1998; 92: 691– 693.

17. Varon ME, Sherer DM, Abramowicz JS et al. Maternal ventricular tachycardia associated with hypomagnesaemia. Am J Obstet Gynecol 1992; 167: 1352– 1355.

18. Widerhorn J, Bhandari AK, Bughi Set al. Fetal and neonatal adverse effects profile of amiodarone treatment during pregnancy. Am Heart J 1991; 122: 1162– 1166.

19. Magee LA, Downar E, Sermer M et al. Pregnancy outcome after gestational exposure to amiodarone in Canada. Am J Obstet Gynecol 1995; 172: 1307– 1311.

20. Janků K, Srp B. Problematika závažných kardiovaskulárních chorob v těhotenství. Česk Gynekol 1993; 58 (Suppl): 38– 43.

21. Chaloupka V, Nekvasil R, Janků K et al. Některé problémy mladistvých s kardioangiopatiemi v souvislosti se stavem těhotenství. Vnitř Lék 1982; 28: 882– 887.

22. Janků K, Martinčík J, Pilka L. Příspěvek k problematice peripartální srdeční nemoci. Vnitř Lék 1977; 23: 1173– 1177.