Tachyarrhythmia during gestation: peculiarities of manifestations and clinic

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Abstract Background Arrhythmias can occur during gestation. The data of peculiarities of development and manifestations of arrhythmias in pregnant women are limited. Purpose To determine the peculiarities of diagnostic and clinic in pregnant women with arrhythmias. Methods In this single-center, prospectively study we consequently included 87 cases of arrhythmias in pregnant (mean age 26.7±3.5 years, mean gestation age 24.6 ±3.3 weeks). The main types of arrhythmias and peculiarities of clinical manifestations were studed. Results In 56% of cases, arrhythmia firstly occurred during current gestation. The most common symptoms of arrhythmia in pregnant women firstly occured in the second trimester at 16 (13;21) weeks of gestation. The most common symptoms of arrhythmia were palpitations (58.6%), general weakness (52.9%), dyspnoe (34%) and dizziness (29.8%). The most common types of arrhythmias were paroxysmal supraventricular tachycardia (54%) and premature contractions (39%). Ventricular tachycardia was diagnosed less frequently – in 7%. Dynamic observation was chosen in 17% in benign course of arrhythmia. Antiarrhythmic drugs were prescribed in 32% in women with severe symptoms and haemodynamic instability. In cases of drug refractory and severe arrhythmias electrophysiological examination and radiofrequency ablation without fluoroscopy were performed in 51%. Despite different arrhythmia management the further course of gestation was benign without major complication: cases of increased incidence of uterine contractile activity and placental abruption were rare (n=2). ). Neonatal outcomes characterized by normal range of fetal birth weight and 5 minute Apgar score. There was no incidence of maternal and fetal mortality and arrhythmia recurrence after ablation in follow-up. Conclusion Arrhythmias may occur for the first time in women during pregnancy. Manifestation and recurrence of arrhythmias are observed mainly in the second trimester at 16 weeks of gestation. The most frequent variants of cardiac arrhythmias are paroxysmal supraventricular tachycardia (54%) and premature contractions (39%), which have a favorable course and prognosis.