Complete Heart Block in Pregnancy Treated With an Internal Cardiac Pacemaker

Ginns, H. M.; Hollinrake, K.

doi:10.1111/j.1471-0528.1970.tb03596.x

Cited by 17 publications

(12 citation statements)

References 3 publications

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“…Insertion of a pacemaker during pregnancy can be done safely. 6,7 Following the procedure, our patient felt much better. Both the remaining gestation period and delivery were uneventful.…”

Section: Discussionmentioning

confidence: 85%

A case of an acquired high-degree AV block in a pregnant woman

Tietge¹,

Daniels²

2008

NHJL

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“…Insertion of a pacemaker during pregnancy can be done safely. 6,7 Following the procedure, our patient felt much better. Both the remaining gestation period and delivery were uneventful.…”

Section: Discussionmentioning

confidence: 85%

A case of an acquired high-degree AV block in a pregnant woman

Tietge¹,

Daniels²

2008

NHJL

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“…Reasons for this are multifaceted, but include improvements in cardiovascular surgery for congenital heart conditions, advancements in pacemaker technologies, and an expanding database that reassures the health care community that successful pregnancies can be accomplished with minimal adverse consequences [1]. Still, the current literature on this subject is quite limited and incomplete [2]- [4]. Recognizing that care of such patients requires a multidisciplinary approach, the obstetrician-gynecologist should be aware of the basic principles related to the care of these types of patients.…”

Section: Discussionmentioning

confidence: 99%

Management of Cardiac Pacemakers in a Pregnant Patient

Grover¹,

Sheth²,

Haines³

et al. 2015

OJOG

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Introduction: Despite the increasing use of permanent cardiac pacemakers in a younger patient population, there are little data related to pregnancy. We present our experience in managing a pregnant patient with a pre-existing pacemaker and review the existing literature to establish management guidelines. Case: A 27-year-old G1 P0 presented for prenatal care in the first trimester of pregnancy. She had a past medical history of bradycardia, hypotension and syncope that required dual chamber cardiac pacemaker placement 6 years earlier, and one episode of left upper extremity venous thrombosis related to replacement of the pacemaker wire 4 years earlier. In the early second trimester, the patient began experiencing light-headedness and breathlessness with exertion. The rate settings of the pacemaker were increased with resolution of the patient's symptoms. The patient underwent primary cesarean section at 39 weeks gestation with delivery of a healthy term infant. Preoperative anesthesia consultation was obtained. The postoperative course was uneventful. Pre-pregnancy pacemaker settings were re-established after the postpartum period. Discussion: The current literature on managing pregnant patients with pre-existing pacemakers is quite limited. Such patients require a multidisciplinary approach to care. Normal physiologic changes in pregnancy may necessitate rate adjustments. Other than routine thromboprophylaxis, no other anticoagulation is needed. Route of delivery is generally based on obstetric indications. During surgery consider using bipolar electrocautery in place of unipolar electrocautery, to reduce electromagnetic interference. Also, the placement of the grounding pad should be as far away from the pacemaker as possible. It should be anticipated that the patient will return to her baseline cardiac status postpartum and therefore pacemaker settings can be adjusted accordingly.

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“…In addition, an analysis of previous reports suggests that the incidence of preterm delivery in CAVB patients is not very high. One report described the case of a pregnant woman with CAVB, in which spontaneous preterm delivery occurred at 30 weeks of gestation without any obvious obstetric cause 12 . However, in all the other previously reported cases, pregnancy continued to at least 36 weeks.…”

Section: Obstetrical Complications In Women With Cavbmentioning

confidence: 97%

“…The most frequent complication of permanent pacemaker implantation in pregnant women is skin irritation and ulceration at the site of implantation 12,13,18,34 . Ginns and Hollinrake have reported a case of breast‐skin ulceration at 16 weeks of gestation as a complication of implantation of a permanent pacemaker due to the increase in breast size 12 . They reimplanted the battery unit of the pacemaker in a subpectoral pocket.…”

Section: Management Of Pregnant Women With Permanent Pacemakermentioning

confidence: 99%

Pregnant Women with Complete Atrioventricular Block: Perinatal Risks and Review of Management

Hidaka

Chiba

Fukushima

et al. 2011

Pacing Clinical Electrophis

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We have summarized the care management of pregnant women with complete atrioventricular block (CAVB) by reviewing data from the published literature as well as our own experience in 32 pregnancies. Obstetrical management of women with a permanent pacemaker implanted prior to conception has been sufficiently reported thus far, and the management of such patients is considered to be of low risk. Since CAVB usually does not cause any specific obstetrical problems during pregnancy, prepregnancy prophylactic placement of a permanent pacemaker is not indicated in all asymptomatic patients. However, when asymptomatic women without pacemakers become pregnant, there is a subset that ultimately develops heart failure during pregnancy. Therefore, close surveillance of pregnant patients with CAVB is warranted. The current increase in the use of permanent pacemakers in young women with symptomatic CAVB will certainly limit the need for intrapartum temporary pacing in patients who do not require a pacemaker before pregnancy. In fact, most women with CAVB, who do not require a permanent pacemaker before delivery, can be safely managed during labor without temporary pacing. However, the clinical symptoms and cardiac function of patients should be carefully followed after delivery, even when pregnancy and delivery are uneventful.

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Complete Heart Block in Pregnancy Treated With an Internal Cardiac Pacemaker

Cited by 17 publications

References 3 publications

A case of an acquired high-degree AV block in a pregnant woman

A case of an acquired high-degree AV block in a pregnant woman

Management of Cardiac Pacemakers in a Pregnant Patient

Pregnant Women with Complete Atrioventricular Block: Perinatal Risks and Review of Management

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