Full Text (PDF)
Case Report

Supra Ventricular Tachycardia in Pregnancy

Aisvarya Kapoor, Uzma Khanam, K Datta

Author Information

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Indian Journal of Emergency Medicine 8(2):p 45-49, April – June 2022. | DOI: https://doi.org/10.21088/ijem.2395.311X.8222.5

How Cite This Article:

Uzma Khanam, Aisvarya Kapoor, K Datta/Supra Ventricular Tachycardia in Pregnancy/Indian J Emerg Med 2022;8(2):45–49

Timeline

Received : March 21, 2022         Accepted : April 16, 2022          Published : June 28, 2022

Abstract

The physiological changes during pregnancy predispose female of new-onset or recurrent arrhythmia. Supraventricular arrhythmia is that the commonest sort of arrhythmia during pregnancy and, although often benign in nature. We describe a complex case of supraventricular arrhythmia during pregnancy and review the currently available literature. In pregnancies complicated by arrhythmia, a follow-up and both maternal and fetal monitoring during pregnancy, delivery and post partum should be made. Diagnostic modalities should be used as in non-pregnant women. All antiarrhythmic drugs cross the placenta, but when necessary, medical treatment should be used. Electrical cardioversion is safe during pregnancy, and electrophysiological study and catheter ablation sometimes performed in selected patients, preferably with zero-fluoroscopy technique. Sometimes, delivering the fetus (if viable) is that the best therapeutic option.


References

  • 1.   de Haas S, Ghossein-Doha C, van Kuijk SMJ, et al, Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta-analysis.Ultrasound Obstet Gynecol 2017;49:177–87. doi:10.1002/uog.17360pmid:http://www.ncbi.nlm.nih.gov/pubmed/28169502CrossRefPubMedGoogle Scholar
  • 2.   Brodsky M, Doria R, Allen B, et al. Newonset ventricular tachycardia during pregnancy. Am Heart J 1992;123:933–4 1 . d o i : 1 0 . 1 0 1 6 / 0 0 0 2 - 8 7 0 3 ( 9 2 ) 9 0 6 9 9-Vpmid:http://www.ncbi.nlm.nih.gov/pubmed/1550003CrossRefPubMedWeb of ScienceGoogle Scholar
  • 3.   Meah VL, Cockcroft JR, Backx K, et al. Cardiac output and related haemodynamics during pregnancy: a series of meta-analyses. Heart2016;102:518-26.doi:10.1136/heartjnl-2015-308476pmid:http://www.ncbi.nlm.nih.gov/pubmed/26794234 Abstract/FREE FullTextGoogle Scholar
  • 4.   Shotan A, Ostrzega E, Mehra A, et al. Incidence of arrhythmias in normal pregnancy and relation to palpitations, dizziness, and syncope. Am J Cardiol 1997;79:1061–4.doi:10.1016/S0002-9149(97)00047-7pmid:http://www.n c b i . n l m . n i h . g o v / p u b m e d / 9 1 1 4 7 6 4 CrossRefPubMedWeb of ScienceGoogle Scholar
  • 5.   Li J-M, Nguyen C, Joglar JA, et al. Frequency and outcome of arrhythmias complicating admission during pregnancy: experience from a high-volume and ethnically-diverse obstetric service. Clin Cardiol 2008;31:538–41. doi:10.1002/clc.20326pmid:http://www.ncbi.nlm.nih.gov/pubmed/19006111CrossRefPub MedWeb of ScienceGoogle Scholar
  • 6.   Tateno S, Niwa K, Nakazawa M, et al. Arrhythmia and conduction disturbances in patients with congenital heart disease during pregnancy: multicenter study. Circ J 2003;67:992–7.doi:10.1253/circj.67.992pmid:http://www.ncbi.nlm.nih.gov/pubmed/14639012 CrossRefPubMedWeb of ScienceGoogle Scholar
  • 7.   Vaidya VR, Arora S, Patel N, et al. Burden of arrhythmia in pregnancy. Circulation 2017;135:619–21.doi:10.1161/CIRCULATIO NAHA.116.026681pmid:http://www.ncbi. nlm.nih.gov/pubmed/28154000 FREE Full TextGoogle Scholar
  • 8.   Silversides CK, Harris L, Haberer K, et al. Recurrence rates of arrhythmias during pregnancy in women with previous tachyarrhythmia and impact on fetal and neonatal outcomes. Am J Cardiol 2006;97:1206–12. doi:10.1016/j.amjcard.2005.11.041pmid:http://www.ncbi.nlm.nih.gov/pubmed/16616027 CrossRefPubMedWeb of ScienceGoogle Scholar
  • 9.   Lee M-S, Chen W, Zhang Z, et al. Atrial fibrillation and atrial flutter in pregnant Women-A population-based study. J Am Heart Assoc 2016;5:e003182. doi:10.1161/JAHA.115.003182pmid:http://www.ncbi.nlm.nih.gov/pubmed/27076563 Abstract/FREE Full TextGoogle Scholar
  • 10.   Lee K-T, Chang S-H, Kuo C-F, et al. Incidence and time course of symptomatic paroxysmal supraventricular tachycardia during pregnancy: a nation-wide database study. ActaCardiol Sin 2020;36:44–9.doi:10.6515/ACS.202001_36(1).20 190707Apmid:http://www.ncbi.nlm.nih.gov/pubmed/31903007PubMedGoogle Scholar
  • 11.   Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J 2018;39:3165–241. doi:10.1093/eurheartj/ehy340pmid:http://www.ncbi.nlm.nih.gov/pubmed/30165544 CrossRefPubMedGoogle Scholar
  • 12.   Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC guidelines for the management of patients with supraventricular tachycardiaThe Task force for the management of patients with supraventricular tachycardia of the European Society of cardiology (ESC). Eur Heart J 2020;41:655–720.doi:10.1093/eurheartj/ehz467pmid:http://www.ncbi.nlm.nih.gov/pubmed/31504425 PubMedGoogle Scholar
  • 13.   Goy J-J, Fromer M. Antiarrhythmic treatment of atrioventriculartachycardias. J Cardiovasc Pharmacol 1991;17:S41–4 0 . d o i : 1 0 . 1 0 9 7 / 0 0 0 0 5 3 4 4 - 1 9 9 1 0 0 1 76 -00008pmid:http://www.ncbi.nlm.nih.gov/pubmed/1723116 PubMedGoogle Scholar
  • 14.   Byerly WG, Hartmann A, Foster DE, et al. Verapamil in the treatment of maternal paroxysmal supraventricular tachycardia. Ann Emerg Med 1991;20:552–4.doi:10.1016/S0196-0644(05)81615-4pmid:http://www.n c b i . n l m . n i h . g o v / p u b m e d / 2 0 2 4 7 9 6 CrossRefPubMedWeb of ScienceGoogle Scholar
  • 15.   Ramlakhan KP, Johnson MR, Roos-Hesselink JW. Pregnancy and cardiovascular disease. Nat Rev Cardiol 2020;17:718–31.doi:10.1038/s41569-020-0390-zGoogle Scholar
  • 16.   Ruys TPE, Roos-Hesselink JW, Hall R, et al. Heart failure in pregnant women with cardiac disease: data from the ROPAC. Heart 2014;100:231–8.doi:10.1136/heartjnl-2013-
  • 17.   Salam AM, Ertekin E, van Hagen IM, et al.Atrial Fibrillation or Flutter During Pregnancy in Patients With Structural Heart Disease: Data From the ROPAC (Registry on Pregnancy and Cardiac Disease). JACC Clin Electrophysiol 2015;1:284–92.doi:10.1016/j.jacep.2015.04.013pmid:http://www.ncbi.nlm.nih.gov/pubmed/29759316Abstract/Free Full TextGoogle Scholar
  • 18.   Drenthen W, Pieper PG, Roos-Hesselink JW, et al. Outcome of pregnancy in women with congenital heart disease: a literature review. J Am Coll Cardiol 2007;49:2303–11.doi:10.1016/j.jacc.2007.03.027pmid:http://www.ncbi.nlm.nih.gov/pubmed/17572244 Free Full TextGoogle Scholar
  • 19.   Szekely P, Snaith L. Atrial fibrillation and pregnancy. Br Med J 1961;1:1407–10. doi:10.1136/bmj.1.5237.1407pmid:http://www.ncbi.nlm.nih.gov/pubmed/13774531 Free Full TextGoogle Scholar
  • 20.   Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European association for Cardio-Thoracic surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of cardiology (ESC) developed with the special contribution of the European heart rhythm association (EHRA) of the ESC. Eur Heart J 2021;42:373–498.doi:10.1093/eurheartj/ehaa612pmid:http://www.ncbi.nlm.nih.gov/pubmed/32860505 CrossRefPubMedGoogle Scholar
  • 21.   Wang Y-C, Chen C-H, Su H-Y, et al. The impact of maternal cardioversion on fetalhaemodynamics. Eur J ObstetGynecolReprod Biol 2006;126:268–9.doi:10.1016/j.ejogrb.2005.11.021pmid:http://www.ncbi.nlm.nih.gov/pubmed/16377063 CrossRefPubMedGoogle Scholar
  • 22.   Barnes EJ, Eben F, Patterson D. Direct current cardioversion during pregnancy should be performed with facilities available for fetal monitoring and emergency caesarean
  • 23.   Masuda K, Ishizu T, Niwa K, et al. Increased risk of thromboembolic events in adult congenital heart disease patients with atrial tachyarrhythmias. Int J Cardiol 2017;234:69–75. doi:10.1016/j.ijcard.2017.02.004pmid:http:// www.ncbi.nlm.nih.gov/pubmed/28209388 PubMedGoogle Scholar
  • 24.   Chang S-H, Kuo C-F, Chou I-J, et al. Outcomes associated with paroxysmal supraventricular tachycardia during pregnancy. Circulation 2017;135:616–8.doi:10.1161 irculationahA. 116.025064pmid:http://www.ncbi.nlm.nih. gov/pubmed/28153999 Free Full TextGoogle Scholar
  • 25.   Fitton CA, Steiner MFC, Aucott L, et al. In-utero exposure to antihypertensive medication and neonatal and child health outcomes: a systematic review. J Hypertens 2017;35:2123–37.doi:10.1097/ HJH.0000000000001456pmid:http://www. n c b i . n l m . n i h . g o v / p u b m e d / 2 8 6 6 1 9 6 1 CrossRefPubMedGoogle Scholar
  • 26.   Driver K, Chisholm CA, Darby AE, et al. Catheter ablation of arrhythmia during pregnancy. J Cardiovasc Electrophysiol 2015;26:698–702. doi:10.1111/jce.12675pmid:http://www. n c b i . n l m . n i h . g o v / p u b m e d / 2 5 8 2 8 8 5 3 CrossRefPubMedGoogle Scholar
  • 27.   Katritsis DG, Boriani G, Cosio FG, et al. European heart rhythm association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by heart rhythm Society (HRS), AsiaPacific heart rhythm Society (APHRS), and SociedadLatinoamericana de Estimulacióncardiaca Y Electrofisiologia (SOLAECE). Europace 2017;19:465–511. doi:10.1093/europace/euw301pmid:http:// www.ncbi.nlm.nih.gov/pubmed/27856540 PubMedGoogle Scholar
  • 28.   Chen G, Wang Y, Proietti R, et al. Zerofluoroscopy approach for ablation of supraventricular tachycardia using the EnsiteNavX system: a multicenter experience. BMC Cardiovasc Disord 2020;20:48. doi:10.1186/s12872-020-01344-0pmid:http:// www.ncbi.nlm.nih.gov/pubmed/32013865 PubMedGoogle Scholar
  • 29.   Koźluk E, Piątkowska A, Kiliszek M, et al. Catheter ablation of cardiac arrhythmias in pregnancy without fluoroscopy: a case control retrospective study. AdvClinExp Med 2017;26:129–34.doi:10.17219/ acem/68275pmid:http://www.ncbi.nlm.nih.gov/pubmed/28397444 PubMedGoogle Scholar
  • 30.   Fink T, Sciacca V, Feickert S, et al. Outcome of cardiac tamponades in interventional electrophysiology. Europace 2020;22:1240–51. doi:10.1093/europace/euaa080pmid:http:// www.ncbi.nlm.nih.gov/pubmed/32500141 PubMedGoogle Scholar
  • 31.   Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. Philadelphia: Lippincott Williams & Wilkins, 2009

Data Sharing Statement

There are no additional data available. All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.

Conflicts of Interest

No conflicts of interest in this work.


About this article


Cite this article

Uzma Khanam, Aisvarya Kapoor, K Datta/Supra Ventricular Tachycardia in Pregnancy/Indian J Emerg Med 2022;8(2):45–49


Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Received Accepted Published
March 21, 2022 April 16, 2022 June 28, 2022

DOI: https://doi.org/10.21088/ijem.2395.311X.8222.5

Keywords

PregnancySupra-Ventricular Tacycardia

Article Level Metrics

Last Updated

Tuesday 07 July 2026, 11:36:07 (IST)


2530

Accesses

3
890
00

Citations


NA
NA
NA

Download citation


Article Keywords


Keyword Highlighting

Highlight selected keywords in the article text.


Timeline


Received March 21, 2022
Accepted April 16, 2022
Published June 28, 2022

licence


Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Access this article



Share