阵发性室上性心动过速对妊娠结局的影响

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open Pub Date : 2025-04-01 DOI:10.1016/j.cjco.2025.01.008

Arya Ardehali BSc , Marla Kiess MD, FRCPC , Valerie Rychel MD, FRCSC , Amanda Barlow MD, FRCPC , Jennifer Oakes MD, FRCSC , Marc Deyell MD, FHRS , Jasmine Grewal MD, FRCPC

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引用次数: 0

摘要

背景：阵发性室上性心动过速（PSVT）是孕妇最常见的心律失常之一。然而，调查妊娠期PSVT风险的研究还很缺乏。在妊娠期，我们的目的是确定(1)新发PSVT女性的比例，(2)既往PSVT史对发作严重程度和治疗的影响，以及(3)与PSVT相关的孕产妇、胎儿或新生儿不良结局的发生率。方法回顾性病例对照研究：圣保罗医院心脏产科门诊（2010-2022年）有PSVT病史或新表现的77例连续妊娠的75例妇女。将产妇产科和胎儿或新生儿不良结局与健康对照组进行比较。结果63例（82%）有PSVT病史，14例（18%）为新发妊娠。有PSVT病史的人中有68%在妊娠期复发。妊娠5年内有近期PSVT病史的妇女比有早期PSVT病史的妇女更容易复发(81% vs 31%, P <；0.001)。该组在怀孕期间也经历了更频繁的PSVT和增加的化学心律转复率（38%对13%，P = 0.05）。PSVT组和对照组的不良产科（8%对2%，P = 0.24）和胎儿或新生儿结局（17%对19%，P = 0.72）发生率相似。结论妊娠期spsvt事件得到了安全的控制，其产科和胎儿或新生儿结局与对照组相似。然而，妊娠期间PSVT的复发是频繁的，并且导致有病史的患者的治疗复杂性，因此需要孕前咨询和导管消融来进行最终治疗。

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Impact of Paroxysmal Supraventricular Tachycardia on Pregnancy Outcomes

Background

Paroxysmal supraventricular tachycardia (PSVT) is one of the most common arrhythmias in pregnant women. However, studies investigating the risk of PSVT in pregnancy are lacking. In pregnancy, we aimed to determine the (1) proportion of women presenting with new-onset PSVT, (2) impact of prior PSVT history on episode severity and management, and (3) rate of adverse maternal and fetal or neonatal outcomes associated with PSVT.

Methods

Retrospective case-control study: 77 consecutive pregnancies in 75 women referred to the St Paul’s Hospital Cardiac Obstetrics Clinic (2010-2022) with a history or new presentation of PSVT. Maternal obstetric and fetal or neonatal adverse outcomes were compared to a healthy control group.

Results

Sixty-three pregnancies (82%) had a history of PSVT and 14 (18%) were new-onset in pregnancy. Sixty-eight percent of those with PSVT history had recurrence in pregnancy. Women with a recent history of PSVT within 5 years of pregnancy were more likely to experience recurrence than women with a remote history (81% vs 31%, P < 0.001). This group also experienced more frequent PSVT during pregnancy and increased rates of chemical cardioversion (38% vs 13%, P = 0.05). There were similar rates of adverse obstetric (8% vs 2%, P = 0.24) and fetal or neonatal outcomes (17% vs 19%, P = 0.72) between the PSVT group and controls.

Conclusions

PSVT events were safely managed in pregnancy with similar obstetric and fetal or neonatal outcomes as controls. However, recurrence of PSVT during pregnancy is frequent and leads to management complexities among those with a history, reinforcing the need for pre-pregnancy counselling and catheter ablation for definitive management.

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