Arrhythmia and Conduction Disturbances in Patients With Congenital Heart Disease During Pregnancy : Multicenter Study

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概要

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• The incidence, manifestation and management of arrhythmia in congenital heart disease (CHD) during pregnancy were evaluated in a multicenter study. Of 126 pregnancies in patients with CHD in 17 institutions from January 1991 to December 2000, 29 cases of pregnancy in 27 patients after cardiac repair (mean age, 29±4.9 years) were identified with arrhythmias (supraventricular tachyarrhythmia (SVT) in 15, ventricular tachycardia (VT) in 9, high-grade atrioventricular block in 4 and sick sinus syndrome in 3) (group A) and 29 control pregnancies from 29 patients with repaired CHD and no arrhythmias (group B). SVT tended to require anti-arrhythmic medication more than VT (10/15 vs 2/9, p=0.04). Nine different types of anti-arrhythmic agents were successfully administered without maternal complications. There were no maternal deaths in either group. In the comparison of group A with group B, there was lower cardiac functional class (8/29, p=004), higher incidence of polysplenia (4/29, p=0.04), and higher incidence of low-birthweight infant (7/29, p=0.02) in the former. It appears that there is a high prevalence of arrhythmias during pregnancy in patients with repaired CHD. Patients with CHD and low cardiac functional class and/or polysplenia could have arrhythmia during pregnancy that results in a low-birthweight infant. Meticulous care for these patients during pregnancy is recommended. (Circ J 2003; 67: 992-997)The incidence, manifestation and management of arrhythmia in congenital heart disease (CHD) during pregnancy were evaluated in a multicenter study. Of 126 pregnancies in patients with CHD in 17 institutions from January 1991 to December 2000, 29 cases of pregnancy in 27 patients after cardiac repair (mean age, 29±4.9 years) were identified with arrhythmias (supraventricular tachyarrhythmia (SVT) in 15, ventricular tachycardia (VT) in 9, high-grade atrioventricular block in 4 and sick sinus syndrome in 3) (group A) and 29 control pregnancies from 29 patients with repaired CHD and no arrhythmias (group B). SVT tended to require anti-arrhythmic medication more than VT (10/15 vs 2/9, p=0.04). Nine different types of anti-arrhythmic agents were successfully administered without maternal complications. There were no maternal deaths in either group. In the comparison of group A with group B, there was lower cardiac functional class (8/29, p=004), higher incidence of polysplenia (4/29, p=0.04), and higher incidence of low-birthweight infant (7/29, p=0.02) in the former. It appears that there is a high prevalence of arrhythmias during pregnancy in patients with repaired CHD. Patients with CHD and low cardiac functional class and/or polysplenia could have arrhythmia during pregnancy that results in a low-birthweight infant. Meticulous care for these patients during pregnancy is recommended. (Circ J 2003; 67: 992-997)

• 社団法人日本循環器学会の論文
• 2003-11-20

著者

• Tateno Shigeru

  Department of Pediatrics, Chiba Cardiovascular Center

• Tateno Shigeru

  Department Of Adult Chd Chiba Cardiovascular Center

• NIWA Koichiro

  Department of Adult Congenital Heart Disease and Pediatric Cardiology, Chiba Cardiovascular Center

• Nakazawa Makoto

  Minami Tohoku Hospital

• Nakazawa Makoto

  Department of Pediatric Cardiology, Heart Institute of Japan, Tokyo Womens Medical University

• Akagi Teiji

  Kurume University

• Shinohara Tokuko

  Department of Pediatric Cardiology, Tokyo Women's Medical University

• Yasuda Toshiaki

  Aichi Children's Health and Medical Center

• Tateno Shigeru

  Department Of Adult Congenital Heart Disease And Pediatrics

• Niwa Koichiro

  Department Of Adult Chd Chiba Cardiovascular Center

• Niwa Koichiro

  Department Of Adult Congenital Heart Disease And Pediatrics

• Shirai Takeaki

  Department Of Adult Congenital Heart Disease And Pediatric Cardiology Chiba Cardiovascular Center

• Shirai Takeaki

  Department Of Adult Congenital Heart Disease And Pediatrics Chiba Cardiovascular Center

• Niwa Koichiro

  Department Of Adult Congenital Heart Disease And Pediatric Cardiology Chiba Cardiovascular Center

• Niwa Koichiro

  Committee On Guideline For Prevention And Management Of Infective Endocarditis Japanese Circulation

• Shinohara Tokuko

  Research committee of Japanese Society of Pediatric Cardiology and Cardiac Surgery

• Akagi Teiji

  Department Of Pediatrics Kurume University School Of Medicine

• Akagi Teiji

  Cardiac Care Unit Okayama University Hospital

• Shinohara Tokuko

  Department Of Adult Congenital Heart Disease And Pediatric Cardiology Chiba Cardiovascular Center

• Niwa Koichiro

  Department Of Adult Congenital Heart Disease And Pediatrics Chiba Cardiovascular Center

• Tateno Shigeru

  Department Of Adult Congenital Heart Disease And Pediatrics Chiba Cardiovascular Center

• Yasuda Toshiaki

  Aichi Children's Health And Medical Center

• Tateno Shigeru

  Departments Of Pediatrics Chiba University School Of Medicine

• Niwa Koichiro

  Departments Of Pediatrics Chiba Cardiovascular Center

• Nakazawa Makoto

  The Gene Cardiovascular Disease Epidemiology Committee Of Japanese Pediatric Cardiology And Cardiac

• Akagi Teiji

  Committee On Guidelines For Management Of Pregnancy In Women With Cardiovascular Disease Japanese Ci

• Nakazawa Makoto

  Department Of Pediatric Cardiology Heart Institute Tokyo Women's Medical University

• Nakazawa Makoto

  Department Of Pediatric Cardiology Heart Institute Of Japan Tokyo Women's Medical College

• Nakazawa Makoto

  Department Of Pediatric Cardiology The Heart Institute Of Japan Tokyo Women's Medical Universit

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