Features of treatment of arrhythmias during pregnancy

Authors

  • S.S. Boev State Institution “Zaporizhia Medical Academy of Postgraduate Education of Ministry of Health of Ukraine”, Zaporizhzhia, Ukraine
  • N.Ya. Dotsenko State Institution “Zaporizhia Medical Academy of Postgraduate Education of Ministry of Health of Ukraine”, Zaporizhzhia, Ukraine
  • I.A. Shekhunova State Institution “Zaporizhia Medical Academy of Postgraduate Education of Ministry of Health of Ukraine”, Zaporizhzhia, Ukraine
  • L.V. Gerasimenko State Institution “Zaporizhia Medical Academy of Postgraduate Education of Ministry of Health of Ukraine”, Zaporizhzhia, Ukraine

DOI:

https://doi.org/10.22141/2224-0586.6.85.2017.111603

Keywords:

cardiovascular pathology, heart rhythm disturbances, pregnancy, review

Abstract

Prevalence of arrhythmias during pregnancy is increased both in women with the structural pathology of the heart, and in patients without a history of cardiovascular pathology. Physiological changes during pregnancy can predispose to the occurrence of arrhythmias, including atrial fibrillation, and contribute to an increase in morbidity and mortality from complications. According to the literature, in organic heart disease, atrial fibrillation is noted in a half of pregnant women, 52 % have ventricular arrhythmia, up to 44 % of pregnant women have supraventricular tachycardia, the risk of the latter is higher in pregnant women with Wolff-Parkinson-White syndrome. Mechanisms of arrhythmia development include hemodynamic, hormonal and functional changes occurring during pregnancy. However, the development of pregnancy is not accompanied by the emergence of specific electrophysiological changes in the structures of the myocardium and the conduction system of the heart. It is extremely important to distinguish those arrhythmias in pregnant women which violate hemodynamics, and also belong to malignant heart rhythm disorders and require specific pharmacotherapy, and in some cases also invasive methods of treatment. In the presented article, approaches to the treatment of arrhythmias during pregnancy are considered for both supporting antiarrhythmic therapy and for arrhythmia arrest, taking into account the classification of drugs according to the safety criteria for the fetus.

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References

Outcome of pregnancy in women with congenital heart disease a literature review / W. Drenthen, P.G. Pieper, J.W. Roos-Hesselink [et al.] // J. Am. Coll. Cardiol. — 2007. — № 49. — Р. 2303-2311.

Predictors of pregnancy complications in women with congenital heart disease / W. Drenthen, E. Boersma, A. Balci [et al.] // Eur. Heart. J. — 2010. — № 31. — Р. 21-24.

Structure of symptomatic heart rhythm disorders and conduction abnormalities in pregnant women / O.Y. Movchan, E.D. Bespalova, O.A. Pitirimova [et al.] // Archiv euromedica. — 2014. — Vol. 4, № 1. — P. 57-61.

Effects of pregnancy on first onset and symptoms of paroxysmal supraventricular tachycardia / S.H. Lee, S.A. Chen, T.J. Wu [et al.] // Am. J. Cardiol. — 1995. — № 76. — Р. 675-678.

Incessant atrial tachycardia accelerated by pregnancy / J.C. Doig, J.M. McComb, D.S. Reid // Br. Heart J. — 1992. — № 67. — Р. 266-268.

Recurrence rates of arrhythmias during pregnancy in women with previous tachyarrhythmia and impact on fetal and neonatal outcomes / C.K. Silversides, L. Harris, K. Haberer [et al.] // Am. J. Cardio. — 2006. — № 97. — Р. 1206-1212.

Prospective multicenter study of pregnancy outcomes in women with heart disease / S.C. Siu, M. Sermer, J.M. Colman [et al.] // Circulation. — 2001. — № 104. — Р. 515.

Risk and predictors for pregnancy-related complications in women with heart disease / S.C. Siu, M. Sermer, D.A. Harrison [et al.] // Circulation. — 1997. — № 96. — Р. 2789-2793.

Risk of complications during pregnancy after Senning or Mustard (atrial) repair of complete transposition of the great arteries / W. Drenthen, P.G. Pieper, M. Ploeg [et al.] // Eur. Heart J. — 2005. — № 26. — Р. 2588-2592.

Cardiac complications relating to pregnancy and recurrence of disease in the offspring of women with atrioventricular septal defects / W. Drenthen, P.G. Pieper, K. van der Tuuk [et al.] // Eur. Heart. J. — 2005. — № 26. — Р. 2581-2585.

Pregnancy and delivery in women after Fontan palliation / W. Drenthen, P.G. Pieper, J.W. Roos-Hesselink [et al.] // Heart. — 2006. — № 92. — Р. 1290-1294.

ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias — executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias) / C. Blomström-Lundqvist, M.M. Scheinman, E.M. Aliot [et al.] // Circulation. — 2003. — № 108. — Р. 1871-1875.

Ведение беременных с желудочковыми аритмиями без структурных изменений сердца — вопросы, которые ждут решения / С.В. Попов, Е.А. Цуринова, Е.С. Жабина, И.Е. Зазерская // Трансляционная медицина. — 2015. — № 2(6). — С. 11-17.

ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias — executive summary // Eur. Heart J. — 2003. — Vol. 24. — P. 857-897.

Oaklty С. Heart disease in Pregnancy, 2nd ed. / С. Oaklty, C.W. Arnes. — Blackwell, 2007. — Р. 122-135.

Pitirimova O.A. Principles of management of pregnancy and childbirth in women with complex forms of cardiac arrhythmia, Dissertation for the degree of candidate of medical scien­ces. — M., 2009.

Flores J.R. Arrhythmias in pregnancy. How and when to treat? / J.R. Flores, M.F. Marquez // Arch. Cardiol. Mex. — 2007. — № 77, Suppl. 2. — Р. 24-31.

Мравян С.Р. Нарушения ритма сердца и проводимости у беременных / С.Р. Мравян, В.А. Петрухин, С. И. Федорова. — М.: Миклош, 2011. — 128 с.

Ермакова А. Частота нарушений ритма и проводимости сердца у женщин в третьем триместре беременности / А. Ермакова, Г.В. Матюшин, Н.Г. Гоголашвили // Сибирское медицинское обозрение. — 2013. — № 1. — С. 49-52.

Hasdemir C. Termination of idiopathic sustained monomorphic ventricular tachycardia by intravenous adenosine in a pregnant woman / C. Hasdemir, O. Musayev, M.B. Alkan [et al.] // Europace. — 2009. — № 11(11). — Р. 1560-1561.

Рахматуллов Ф.К. Экстрасистолия, суправентрикулярная тахикардия, антероградное проведение у небеременных и беременных женщин / Ф.К. Рахматулов, С.В. Климова, Е.Г. Зиновьева // Известия высших учебных заведений. Поволжский регион. Медицинские науки. — 2014. — № 2(30). — C. 96-107.

Widerhorn J. WPW syndrome during pregnancy: increased incidence of supraventricular arrhythmias / J. Widerhorn, A.L. Widerhorn, S.H. Rahimtoola [et al.] // Am. Heart J. — 1992. — № 123(3). — Р. 796-798.

Silversides C.K. Physiological changes in pregnancy // Heart disease in pregnancy, 2nd ed. / C.K. Silversides, J.M. Colman. — Blackwell Publishing, Malden, 2007. — Р. 6.

Elkayam U. Hemodynamics and cardiac function during normal pregnancy and puerperium // Cardiac problems in pregnancy, 3rd ed. / U. Elkayam, N. Gleicher. — New York, 1998. — Р. 3.

Cardiac Arrhythmias — New Considerations / M. Craina, G. Furău, R. Niţu // Arrhythmias in Pregnancy. — 2012. — Р. 498-514.

Guidelines on the management of cardiovascular diseases during pregnancy / V. Regitz-Zagrosek [et al.] // Eur. Heart J. — 2011. — Vol. 32(24). — P. 3147-3197.

Ferrero S. Maternal arthmias during pregnancy / S. Ferrero, B.M. Colombo, N. Ragni // Arch. Gynecol. Obstet. — 2004. — № 269. — Р. 244-253.

Jastrow N. Prediction of complications in pregnant women with cardiac diseases referred to a tertiary / N. Jastrow, P. Meyer, P. Khairy [et al.] // International Journal of Cardiology. — 2011. — Vol. 151, Issue 2. — Р. 209-213.

Joglar J.A. Treatment of cardiac arrhythmias during pregnancy: safety considerations / J.A. Joglar, R.L. Page // Drug. Saf. — 1999. — № 20. — Р. 85.

Burden of Arrhythmia in Pregnancy / R. Vaidya Vaibhav, Arora Shilpkumar, Patel Nileshkumar [et al.] // Circulation. — 2017. — Vol. 135. — Р. 619-621.

European Society of Gynecology (ESG), Association for European Paediatric Cardiology (AEPC), German Society for Gender Medicine (DGesGM), et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC) // Eur. Heart J. — 2011. — № 32. — Р. 3147.

Two cases of cardiac sarcoidosis in pregnant women with supraventricular arrhythmia / E. Ertekin, S. Moosa, J.W. Roos-Hesselink [et al.] // Cardiovasc. J. Afr. — 2015. — № 26(2). — Р. 96-100.

Диагностика и лечение сердечно-сосудистых заболеваний при беременности: Российские рекомендации // РКЖ. — 2013. — № 4(102), прилож. 1. — 40 с.

Tromp C.H.N. Electrical cardioversion during pregnancy: safe or not? / C.H.N. Tromp, A.C.M. Nanne, P.J.M. Pernet // Neth. Heart J. — 2011. — № 19. — Р. 134-136.

Рекомендации ЕОК по лечению ССЗ у беременных / Рациональная фармакотерапия в кардиологии. — 2012. — Прилож. № 3. — С. 38-42.

Рекомендации по диагностике и лечению сердечно-сосудистых заболеваний при беременности // Кардиоваскулярная терапия и профилактика. — 2010. — № 9(6). — С. 19-66.

Joglar J. Management of arrhythmia syndromes during pregnancy / J. Joglar, A. Jose, R. Page // Current Opinion in Cardiology. — 2014 — Vol. 29, Issue 1. — Р. 36-44.

Camm A.J. Atrial fibrillation and risk / A. J. Camm // Clin. Cardiol. — 2012. — № 35, Suppl. 1. — Р. 1-2.

Cardioversion in late pregnancy: a case report / V. Singh, P. Bhakta, J. Hashmi [et al.] // Acta Anaesth. Belg. — 2014. — № 65. — Р. 105-107.

Radiofrequency ablation os initial therapy in paroxysmal atrial fibrillation / C. Nielsen, A. Johonnessen, P. Rggtikoinen [et al.] // N. Engl. J. Med. — 2012. — № 367. — Р. 1587-1595.

Conceptus radiation dose and risk from cardiac catheter ablation procedures / J. Damilakis, N. Theocharopoulos, K. Perisinakis [et al.] // Circulation. — 2001. — № 104. — Р. 893-897.

ACCF/AHA/HRS Focused Update on the Management of Patients With Atrial Fibrillation (Updating the 2006 Guideline) A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines // Circulation. — 2011. — № 123. — Р. 104-123.

Electrical cardioversion in the treatment of cardiac arrhythmias during pregnancy-case report and review of literature / K. Gałczyński, B. Marciniak, J. Kudlick [et al.] // Ginekologia Polska. — 2013. — № 84(10). — Р. 882-887.

Thrombophilia, Antithrombotic Therapy, and Pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed.: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines / S.M. Bates, I.A. Greer, S. Middeldorp [et al.] // Chest. — 2012. — Vol. 141. (Suppl. 2). — Р. 691-736; doi:10.1378/chest.11–2300.

Ребров Б.А. Симпозиум «Нарушения ритма сердца при беременности» / Б.А. Ребров, О.А. Реброва // Новости медицины и фармации. — 2011. — № 13-14. — С. 45-48.

Published

2022-01-27

How to Cite

Boev, S., Dotsenko, N., Shekhunova, I., & Gerasimenko, L. (2022). Features of treatment of arrhythmias during pregnancy. EMERGENCY MEDICINE, (6.85), 30–36. https://doi.org/10.22141/2224-0586.6.85.2017.111603

Issue

Section

Scientific Review