New-onset ventricular tachycardia during pregnancy

https://doi.org/10.1016/0002-8703(92)90699-VGet rights and content

Abstract

During evaluation for palpitations, presyncope, or syncope, seven pregnant women had documented ventricular tachycardia. Before pregnancy none had a history of significant cardiac disease or symptomatic arrhythmia. The tachycardia rate ranged from 117 to 250 beats/min and lasted up to 65 seconds. Arrhythmia evaluation in five of the patients suggested catecholamine-sensitive ventricular tachycardia. This diagnosis was supported by either a positive relation to exercise or isoproterenol infusion, suppression of arrhythmia by β-blockade or sleep, and lack of induction of arrhythmia by programmed electrical stimulation of the heart. The arrhythmias resolved in one patient soon after evaluation and in one other patient after 2 months of controlling therapy. Five other patients continued to receive therapy throughout pregnancy. Delivery was accomplished in all patients without significant maternal or neonatal complications.

References (71)

  • AE Buxton et al.

    Repetitive, monomorphic ventricular tachycardia: clinical and electrophysiologic characteristics in patients with and patients without organic heart disease

    Am J Cardiol

    (1984)
  • MA Brodsky et al.

    Antiarrhythmic efficacy of solitary beta-adrenergic blockade for patients with sustained ventricular tachyarrhythmias

    Am Heart J

    (1989)
  • MA Brodsky et al.

    Enhanced survival in patients with heart failure and life-threatening ventricular tachyarrhythmias

    Am Heart J

    (1986)
  • WM Barron et al.

    Plasma catecholamine responses to physiologic stimuli in normal human pregnancy

    Am J Obstet Gynecol

    (1986)
  • SV Pose et al.

    Effect of l-epinephrine infusion on uterine contractility and cardiovascular system

    Am J Obstet Gynecol

    (1962)
  • P Renou et al.

    Autonomic control of fetal heart rate

    Am J Obstet Gynecol

    (1969)
  • GK Oakes et al.

    Effect of propranolol infusion on the umbilical and uterine circulations of pregnant sheep

    Am J Obstet Gynecol

    (1976)
  • AA Levitan et al.

    Propranolol therapy during pregnancy and lactation

    Am J Cardiol

    (1973)
  • CM Cottrill et al.

    Propranolol therapy during pregnancy, labor, and delivery: evidence for transplacental drug transfer and impaired neonatal drug disposition

    J Pediatr

    (1977)
  • SC Pruyn et al.

    Long-term propranolol therapy in pregnancy: maternal and fetal outcome

    Am J Obstet Gynecol

    (1979)
  • JL Bullock et al.

    Treatment of thyrotoxicosis during pregnancy with propranolol

    Am J Obstet Gynecol

    (1975)
  • A Habib et al.

    Effects on the neonate of propranolol administered during pregnancy

    J Pediatr

    (1977)
  • GI Fiddler

    Propranolol and pregnancy

    Lancet

    (1974)
  • JS Schroeder et al.

    Repeated cardioversion during pregnancy

    Am J Cardiol

    (1971)
  • JP Bruner et al.

    Pregnancy in a patient with idiopathic long QT syndrome

    Am J Obstet Gynecol

    (1984)
  • PC O'Connor et al.

    Propranolol and pregnancy outcome

    Lancet

    (1981)
  • J Mackenzie
  • CM Peters et al.

    Orthostatic paroxysmal ventricular tachycardia

    Am Heart J

    (1946)
  • CR Rally et al.

    Paroxysmal ventricular tachycardia without evident heart disease

    Can Med Assoc J

    (1962)
  • LS Gettes et al.

    Long-term prevention of paroxysmal arrhythmias with propranolol therapy

    Am J Med Sci

    (1967)
  • JR Ledwich et al.

    Idiopathic recurrent ventricular fibrillation

    Am J Cardiol

    (1969)
  • RO Russell

    Paroxysmal ventricular tachycardia associated with pregnancy

    Ala J Med Sci

    (1969)
  • RC Spritzer et al.

    Serious arrhythmias during labor and delivery in women with heart disease

    JAMA

    (1970)
  • RL Reed et al.

    Propranolol therapy throughout pregnancy: a case report

    Anesth Analg

    (1974)
  • EJ Shaxted et al.

    Disopyramide in pregnancy: a case report

    Curr Med Res Opin

    (1979)
  • Cited by (132)

    • Obstetric and fetal/neonatal outcomes in pregnant women with frequent premature ventricular complexes and structurally normal heart

      2023, International Journal of Cardiology
      Citation Excerpt :

      There was no substantial difference in newborn weight between the treated and non-treated groups. Brodsky et al. [33] reported that suppression of new-onset VT by β-blockade during pregnancy was not complicated by significant maternal or neonatal complications. However, Ersboll et al. [34] found that β-blocker therapy was independently associated with increased risk of small for gestational age among 175 pregnant women with structural heart disease.

    • Arrhythmias in Pregnancy

      2022, JACC: Clinical Electrophysiology
      Citation Excerpt :

      VT in the absence of structural heart disease is typically hemodynamically stable and associated with a good prognosis (50). It is often catecholamine sensitive, and treatment with β-blockers is usually effective (17). Propranolol or metoprolol should be continued throughout pregnancy and the post-partum period (51,52).

    View all citing articles on Scopus
    View full text