During pregnancy and puerperium, 13% of women with bileaflet MVP and 20% with moderate-severe MR developed arrhythmias, which were usually benign.
Arrhythmias during pregnancy and puerperium in women with mitral valve prolapse are relatively common but usually benign, with higher risk observed in those with bileaflet prolapse or moderate-severe mitral regurgitation.
Absolute Event Rate: 0% vs 0%
Abstract Background Limited data exist regarding the risk of arrhythmias in women with mitral valve prolapse (MVP) during pregnancy and puerperium. Purpose To describe the incidence of arrhythmias in patients with MVP during pregnancy and puerperium and to identify risk factors for their occurrence. Methods We conducted a retrospective study of females diagnosed with MVP who underwent a delivery at our tertiary center. Patients without an echocardiogram were excluded. Data included comorbidities, arrhythmias, use of antiarrhythmic medications, electrocardiographic findings, echocardiographic findings, 24-hour Holter monitoring results, and cardiac magnetic resonance (CMR) imaging. Results We identified 103 patients with MVP who underwent delivery at our institution in 01/1997-02/2025. After excluding 53 patients without an echocardiogram, the final cohort included 50 patients (mean age 31, mean left ventricular ejection fraction 60%). Bileaflet MVP was present in 46%, moderate-severe mitral regurgitation (MR) in 20%, inverted T waves in inferior leads in 12%. CMR imaging was performed in five women, with one showing late gadolinium enhancement (1% of the myocardium). No women were implanted with an implantable cardioverter-defibrillator before pregnancy. Two women were on beta-blockers during pregnancy. Overall, 9 women experienced arrhythmic events. Three women had arrhythmias prior to pregnancy, including non-sustained ventricular tachycardia (NSVT) and atrioventricular nodal reentrant tachycardia (AVNRT). Four women developed arrhythmias during pregnancy or delivery (one during the first pregnancy and 3 during the second), including atrial fibrillation, AVNRT and NSVT. After completion of puerperium and during a mean follow up of 6.9 years, five women developed arrhythmias, including AVNRT, atrial tachycardia, NSVT, and ventricular fibrillation. Two women required ICD implantation and one received a loop recorder. No deaths occurred. During pregnancy and puerperium, 13% of women with bileaflet MVP experienced arrhythmias compared to none of those with isolated anterior leaflet MVP or isolated posterior leaflet MVP. Of those with moderate-severe MR, 20% developed arrhythmias during pregnancy compared to 5% of those with no or mild MR. Conclusion Our study demonstrates that arrhythmias during pregnancy and puerperium in patients with MVP are not uncommon but are usually benign. Suggested risk factors include bileaflet prolapse, moderate-severe MR, and second delivery.
Gefen et al. (Sat,) reported a other. During pregnancy and puerperium, 13% of women with bileaflet MVP and 20% with moderate-severe MR developed arrhythmias, which were usually benign.