PT  - JOURNAL ARTICLE
AU  - Anke R Hodes
AU  - Crystal Tichnell
AU  - Anneline S J M te Riele
AU  - Brittney Murray
AU  - Judith A Groeneweg
AU  - Abhishek C Sawant
AU  - Stuart D Russell
AU  - Karin Y van Spaendonck-Zwarts
AU  - Maarten P van den Berg
AU  - Arthur A Wilde
AU  - Harikrishna Tandri
AU  - Daniel P Judge
AU  - Richard N W Hauer
AU  - Hugh Calkins
AU  - J Peter van Tintelen
AU  - Cynthia A James
TI  - Pregnancy course and outcomes in women with arrhythmogenic right ventricular cardiomyopathy
AID  - 10.1136/heartjnl-2015-308624
DP  - 2016 Feb 15
TA  - Heart
PG  - 303--312
VI  - 102
IP  - 4
4099  - http://heart.bmj.com/content/102/4/303.short
4100  - http://heart.bmj.com/content/102/4/303.full
SO  - Heart2016 Feb 15; 102
AB  - Objectives To characterise pregnancy course and outcomes in women with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C).Methods From a combined Johns Hopkins/Dutch ARVD/C registry, we identified 26 women affected with ARVD/C (by 2010 Task Force Criteria) during 39 singleton pregnancies >13 weeks (1–4 per woman). Cardiac symptoms, treatment and episodes of sustained ventricular arrhythmias (VAs) and heart failure (HF) ≥ Class C were characterised. Obstetric outcomes were ascertained. Incidence of VA and HF were compared with rates in the non-pregnant state. Long-term disease course was compared with 117 childbearing-aged female patients with ARVD/C who had not experienced pregnancy with ARVD/C.Results Treatment during pregnancy (n=39) included β blockers (n=16), antiarrhythmics (n=6), diuretics (n=3) and implantable cardioverter defibrillators (ICDs) (n=28). In five pregnancies (13%), a single VA occurred, including two ICD-terminated events. Arrhythmias occurred disproportionately in probands without VA history (p=0.045). HF, managed on an outpatient basis, developed in two pregnancies (5%) in women with pre-existing overt biventricular or isolated right ventricular disease. All infants were live-born without major obstetric complications. Caesarean sections (n=11, 28%) had obstetric indications, except one (HF). β Blocker therapy was associated with lower birth weight (3.1±0.48 kg vs 3.7±0.57 kg; p=0.002). During follow-up children remained healthy (median 3.4 years), and mothers were without cardiac mortality or transplant. Neither VA nor HF incidence was significantly increased during pregnancy. ARVD/C course (mean 6.5±5.6 years) did not differ based on pregnancy history.Conclusions While most pregnancies in patients with ARVD/C were tolerated well, 13% were complicated by VA and 5% by HF.