New-onset ventricular tachycardia during pregnancy

Brodsky, Michael A.; Doria, Robert; Allen, Byron J.; Sato, David A.; Thomas, G D; Sada, Mark J.

doi:10.1016/0002-8703(92)90699-v

Cited by 142 publications

(70 citation statements)

References 59 publications

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“…These alterations might contribute to the increased occurrence of arrhythmias that have been described previously. [3][4][5] Severe abnormal uterine perfusion with subsequent pathological outcomes is associated with altered ventricular repolarization of the maternal heart that precedes clinical symptoms. Therefore, ECG assessment should be considered for pregnancy monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is evidence suggesting that pregnancy can exacerbate preexisting underlying arrhythmias or even cause de novo arrhythmias. [3][4][5] Multiple factors might be involved in the arrhythmogenesis, including increased hemodynamic stress on the cardiovascular system. Ventricular repolarization might be altered during pregnancy because of changes in circulating hormones, electrolyte levels 6 and increased sympathetic neural outflow, 7 thereby inducing ventricular arrhythmias.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal changes in QT interval variability and rate adaptation in pregnancies with normal and abnormal uterine perfusion

et al. 2010

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The maternal heart significantly adapts to the circulatory needs of pregnancy, but the effect of pregnancy on ventricular repolarization is poorly understood. The aim of this study was to quantify longitudinal changes in ventricular repolarization during pregnancy. Monthly electrocardiographs (ECGs) were recorded in 32 pregnant women with normal uterine perfusion and 32 pregnant women with abnormal perfusion, starting from the 20th week of gestation until 3 days postpartum. Ventricular repolarization was assessed through various QT interval variability and heart rate adaptation measures. The pregnancy outcomes of all women with normal perfusion were normal. Among pregnancies with abnormal uterine perfusion, 15 pregnancy outcomes were normal, but 17 pregnancies developed preeclampsia and/or small-for-gestational-age infants. In pregnancies with normal perfusion, the QT c interval was unaltered, but the QT interval-heart rate hysteresis lag was shorter and the QT interval-heart rate regression residual was higher compared with those of a control group of 10 healthy non-pregnant women. Pregnancies with abnormal uterine perfusion that developed pathological outcomes showed significantly smaller QT interval-heart rate regression residuals and a trend towards shorter QT c intervals compared with pregnant women with normal perfusion. In conclusion, pregnancy has a significant effect on ventricular repolarization. Pregnancies with abnormal uterine perfusion and subsequent pathological outcomes are paralleled by changes in ventricular repolarization that precede clinical symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Longitudinal changes in QT interval variability and rate adaptation in pregnancies with normal and abnormal uterine perfusion

et al. 2010

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“…It is often catecholamine sensitive, and treatment of outflow tract VT with cardioselective β-blockers in pregnant patients is usually effective. 50,51 Sotalol or flecainide may be considered in patients with significant symptoms that fail β-blocker therapy. Fascicular VT is typically verapamil sensitive, and verapamil can be used for both acute termination and prevention of recurrences.…”

Section: Vt In Pregnant Women Without Structural Heart Diseasementioning

confidence: 99%

Contemporary Management of Arrhythmias During Pregnancy

Enriquez

Economy

Tedrow

2014

Circ: Arrhythmia and Electrophysiology

130

119

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“…Some authors have suggested an increase in the frequency of paroxysmal supraventricular tachycardic episodes during pregnancy, with some of the patients experiencing these episodes for the first time [9][10][11] . Other patients who have a history of arrhythmias before pregnancy show an increase in the frequency, duration and severity of these arrhythmias during pregnancy 4 . Palpitations, dizziness, presyncope and, eventually, syncope may occur during pregnancy, but the etiology of these manifestations is still unclear.…”

Section: Discussionmentioning

confidence: 99%

“…However, patients with underlying heart disease and significant left ventricular dysfunction are more susceptible to malignant arrhythmias, which are poorly tolerated and may place the pregnant woman's life at risk due to sudden death 2 . An increase in the incidence of cardiac arrhythmias during pregnancy, including ventricular tachycardia, has been reported in patients with and without heart disease 3,4 .…”

mentioning

confidence: 99%