Outcomes of Maternal Supraventricular Tachycardia During Pregnancy.

Introduction: While supraventricular tachycardia (SVT) is generally considered benign, recent data suggest that SVT during pregnancy may be associated with adverse outcomes.

Methods and results: We queried the National Inpatient Sample (NIS) from 2016 to 2021 to identify pregnancy-related hospitalizations with a diagnosis of SVT. Diagnoses, patient characteristics, and endpoints were ascertained using ICD-10 codes. Out of 23.5 million pregnancy-related hospitalizations, 30 215 (0.14%) included a diagnosis of SVT. Patients with SVT were older and had a higher prevalence of cardiovascular and non-cardiovascular comorbidities. In-hospital mortality was significantly higher in women with SVT (0.55 vs. 0.01%, p < 0.001). After adjustment for baseline differences, in-hospital mortality remained significantly higher in women with SVT (adjusted odds ratio [aOR] 4.68, 95% confidence interval [CI]: 2.94-7.46). Risk of cardiogenic shock (aOR 4.67, 95% CI: 3.12-7.00), need for mechanical circulatory support (aOR 4.93, 95% CI: 2.93-8.30) and incidence of pre-eclampsia or eclampsia (aOR 1.14, 95% CI: 1.04-1.24) were also greater in women with SVT. Of the 30 215 hospitalizations with SVT, only 190 women underwent ablation during hospitalization (0.63%). Among pregnant women undergoing ablation, the incidence of in-hospital mortality was too low to report per NIS guidelines (n < 10).

Conclusions: A diagnosis of SVT was present in 0.14% of pregnancy-related hospitalizations and was associated with an increased risk of in-hospital mortality, cardiogenic shock, need for mechanical circulatory support, and pre-eclampsia/eclampsia.