828: Effect of previous history of cardiac arrhythmias on the clinical course and pregnancy outcome of women who develop arrhythmias during pregnancy

Article Outline

• Objective
• Study Design
• Results
• Conclusion
• Copyright

Back to Article Outline

Objective 

To determine whether pregnancy course and outcomes of women diagnosed with heart rhythm abnormalities during gestation or in the immediate postpartum depends on previous history of cardiac arrhythmia.

Back to Article Outline

Study Design 

Retrospective cohort study of pregnant women diagnosed with cardiac arrhythmia at a tertiary care center from January 1st 2004 to December 31st 2008. Diagnosis was confirmed by Holter monitor. Tachyarrhythmias included atrial fibrillation (AF), supraventricular tachycardia (SVT), and idiopathic sinus tachycardia (HR 130 bpm). Bradyarrhythmias were first, second and, third degree atrioventricular heart block (AVHB) as well as idiopathic sinus bradycardia (SB) (HR 50 bpm). Clinical outcomes were compared between women with and without history of arrhythmia (HOA). Student's t test and Fisher's exact test were used for statistical analysis (significance: P <0.05).

Back to Article Outline

Results 

Eighty women were included 37 (46.3%) with and 43 (53.7%) without HOA. Maternal demographic characteristics were similar between the groups. Nineteen (51.3%) women with HOA and 3 (6.9%) without HOA were diagnosed with arrhythmia in the first half of gestation (P <0.05). SVT was significantly higher in women with HOA than in those without HOA (12/37 vs 3/43; P<0.05). SB was more frequent when HOA was negative (6/43 vs 0/37; P <0.05). AF, ST, AVHB were not significantly different between the groups. Incidence of preeclampsia and gestational diabetes was similar between the groups. Birthweight and Apgar scores were also similar. Preterm delivery was two times higher in women with than in those without HOA (21.6% vs 9.3%) but the difference did not reach significance. Medical cardioversion and hospitalization were significantly more common in women with HOA (9/37 vs 1/43 and 23/37 vs 12/43, respectively; P <0.05). There were no maternal or perinatal mortality.

Back to Article Outline

Conclusion 

Preexistent arrhythmia was associated with earlier onset of arrhythmias in pregnancy, higher number of clinical interventations, as well as higher rate of preterm delivery.