Catecholaminergic Ventricular Tachycardia, Pregnancy and Teenager: Are They Compatible?

Abstract

Arrhythmias in pregnancy are becoming more common given more available and effective medical, ablation and device treatment options. Several changes associated with pregnancy, increased blood volume, cardiac output, and heart rate secondary to an increased sympathetic state, facilitate more frequent occurrences of arrhythmias throughout the pregnancy and during labor and delivery. We present a case of successful pregnancy in a teenage female with a previous diagnosis of CPVT, followed by a review of the literature.

Catecholaminergic polymorphic ventricular tachycardia in pregnancy: a case report

“…This contrasts with our patient who had an implanted ICD, and presented with recurrent episodes of arrhythmia throughout pregnancy that increased during the labor process but were successfully managed with the implementation of a carefully designed management protocol [5]. An earlier case report involved a young woman managed with an ICD and propranolol and propafenone [4]. She had two episodes of admission for maternal arrhythmia secondary to non-adherence with medications.…”

“…Two case reports of CPVT document ICD shocks in pregnancy: one patient undergoing three shocks for appropriate arrhythmias in the first trimester [3]. The other patient underwent a single ICD shock at 26 weeks gestation in the setting of medication noncompliance and subsequently delivered a preterm infant at 30 weeks gestation as a result of preterm prelabor rupture of membranes [4]. A larger retrospective review of 228 pregnancies showed no increased risk of events during or after pregnancy; however, the study was limited by a small patient population further confounded by relatively rare rates of cardiac events.…”

“…During the labor process she continued her therapeutic regimen, had cardiac telemetry, and received an early epidural for pain management. She had a vaginal delivery of a preterm infant which tested negative for the RYR2 mutation [4].…”

Catecholaminergic Polymorphic Ventricular Tachycardia in Pregnancy

“…Literature regarding management and outcomes of catecholaminergic polymorphic VT in pregnant women is scarce. [5][6][7] We present a case of a woman with catecholaminergic polymorphic VT managed in our Heart and Pregnancy Program (Video 1).…”

Peripartum management of a patient with catecholaminergic polymorphic ventricular tachycardia

“…There is very limited literature regarding the management of patients with CPVT during the peripartum period. Our literature search found only four case reports describing their experience with labor and delivery in patients with polymorphic VT (Ahmed & Phillips, 2016; Burrows, Fox, Biblo, & Roth, 2013; Friday, Moak, Fries, & Iqbal, 2015; Gogle & Kemp, 2018). Given that this is a rare clinical scenario, and there are a lack of guidelines for its management, approaches have varied within all cases reported, including a clinical dilemma about the need to treat or not to treat an asymptomatic patient (Kotschet, Hunter, Kroushev, & Wallace, 2017).…”