Pregnancy course and outcomes in women with arrhythmogenic right ventricular cardiomyopathy.
Heart
; 102(4): 303-12, 2016 02 15.
Article
en En
| MEDLINE
| ID: mdl-26719359
ABSTRACT
OBJECTIVES:
To characterise pregnancy course and outcomes in women with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C).METHODS:
From a combined Johns Hopkins/Dutch ARVD/C registry, we identified 26 women affected with ARVD/C (by 2010 Task Force Criteria) during 39 singleton pregnancies >13â weeks (1-4 per woman). Cardiac symptoms, treatment and episodes of sustained ventricular arrhythmias (VAs) and heart failure (HF) ≥ Class C were characterised. Obstetric outcomes were ascertained. Incidence of VA and HF were compared with rates in the non-pregnant state. Long-term disease course was compared with 117 childbearing-aged female patients with ARVD/C who had not experienced pregnancy with ARVD/C.RESULTS:
Treatment during pregnancy (n=39) included ß blockers (n=16), antiarrhythmics (n=6), diuretics (n=3) and implantable cardioverter defibrillators (ICDs) (n=28). In five pregnancies (13%), a single VA occurred, including two ICD-terminated events. Arrhythmias occurred disproportionately in probands without VA history (p=0.045). HF, managed on an outpatient basis, developed in two pregnancies (5%) in women with pre-existing overt biventricular or isolated right ventricular disease. All infants were live-born without major obstetric complications. Caesarean sections (n=11, 28%) had obstetric indications, except one (HF). ß Blocker therapy was associated with lower birth weight (3.1±0.48â kg vs 3.7±0.57â kg; p=0.002). During follow-up children remained healthy (median 3.4â years), and mothers were without cardiac mortality or transplant. Neither VA nor HF incidence was significantly increased during pregnancy. ARVD/C course (mean 6.5±5.6â years) did not differ based on pregnancy history.CONCLUSIONS:
While most pregnancies in patients with ARVD/C were tolerated well, 13% were complicated by VA and 5% by HF.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Cardiovasculares del Embarazo
/
Displasia Ventricular Derecha Arritmogénica
/
Nacimiento Vivo
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
País/Región como asunto:
America do norte
/
Europa
Idioma:
En
Revista:
Heart
Asunto de la revista:
CARDIOLOGIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Países Bajos