Key result
Dual-chamber ICD implantation during pregnancy safely enables ventricular pacing and uncomplicated delivery in NKX2-5 mutation.
Why the study?
Limited guidelines exist for managing conduction mutations such as NKX2-5 during pregnancy, where arrhythmias and conduction disorders are amplified by physiological changes.
Does dual-chamber ICD implantation safely treat progressive AV block and provide primary prevention in a pregnant patient with an NKX2-5 mutation?
Case Report (n=1)
Does dual-chamber ICD implantation safely treat progressive AV block and provide primary prevention in a pregnant patient with an NKX2-5 mutation?
This case demonstrates the safety and feasibility of ICD implantation during pregnancy for patients with high-risk genetic mutations like NKX2-5 that cause progressive conduction disease and sudden cardiac death risk.
Answers are grounded in this paper and cite their sources.
May support ICD feasibility in select pregnant NKX2-5 carriers; hypothesis-generating and requires prospective confirmation before practice change.
BACKGROUND: Arrhythmias and conduction disorders are relatively common during pregnancy and are often amplified by the physiological changes of gestation. Although new-onset complete heart block is uncommon, it has been linked to mutations in the NKX2-5 gene, which is associated with congenital heart disorders and progressive conduction system defects. CASE SUMMARY: We present the case of a pregnant woman with an NKX2-5 gene mutation who developed progressive atrioventricular nodal disease and chronotropic incompetence. She underwent dual-chamber implantable cardioverter-defibrillator placement, with a well-tolerated procedure and an uncomplicated pregnancy and delivery. DISCUSSION: This case demonstrates the feasibility of device implantation during pregnancy and highlights the importance of genetic insight and multidisciplinary care in managing complex cardiac conditions. TAKE-HOME MESSAGES: Limited guidelines exist for the management of conduction mutations such as NKX2-5 during pregnancy. More research, data, and shared clinical experience are needed to better guide clinicians into multidisciplinary, timely and individualized management plans to ensure optimal maternal and fetal outcomes.
No takes yet. Share an insight, caveat, or question.
Alhmouz et al. (2025) conducted a case report in Progressive atrioventricular nodal disease and chronotropic incompetence (n=1). Dual-chamber implantable cardioverter-defibrillator (ICD) was evaluated on Maternal and fetal outcomes following device implantation. Dual-chamber ICD placement was safely performed in a pregnant patient with an NKX2-5 gene mutation, resulting in effective ventricular pacing and an uncomplicated delivery.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: