What is the clinical evidence from this study?

Study design: Observational. Population: Congenital heart disease during pregnancy (n=56). Intervention: Arrhythmia during pregnancy vs. No arrhythmia during pregnancy. Primary outcome: Incidence of low-birthweight infants (p=0.02).

What question did this study set out to answer?

To evaluate the incidence, clinical manifestation, and management of arrhythmias during pregnancy in patients with repaired congenital heart disease.

January 1, 2003Circulation JournalOpen Access

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

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Key result

Arrhythmias during pregnancy in women with repaired congenital heart disease were associated with a significantly higher incidence of low-birthweight infants compared to those without arrhythmias (24.1% vs 3.4%, p=0.02).

Why the study?

Does the presence of arrhythmia during pregnancy in patients with repaired congenital heart disease worsen maternal and fetal outcomes?

Population

58 pregnancies in patients with repaired congenital heart disease selected from a cohort of 126 pregnancies…

Comparison

Presence of arrhythmia during pregnancy vs No arrhythmia during pregnancy

Design

Case-control

Follow-up

during pregnancy

Authors

STShigeru TatenoChiba Kaihin Municipal Hospital KNKoichiro NiwaAdult Congenital Heart Disease MNMakoto NakazawaAichi Mizuho Junior College

Discussion

Member takes

Implication

Arrhythmia in pregnant women with repaired CHD may signal higher low-birthweight risk; leaves open causality and need for prospective studies.

Key Points

To evaluate the incidence, clinical manifestation, and management of arrhythmias during pregnancy in patients with repaired congenital heart disease.
Multicenter study evaluating 126 pregnancies in patients with congenital heart disease across 17 institutions from January 1991 to December 2000.
Identified 29 pregnancies (in 27 patients, mean age 29±4.9 years) with arrhythmias including supraventricular tachyarrhythmia, ventricular tachycardia, high-grade AV block, and sick sinus syndrome (Group A), compared with 29 arrhythmia-free control pregnancies in repaired congenital heart disease (Group B).
Supraventricular tachyarrhythmia required anti-arrhythmic medication significantly more often than ventricular tachycardia (10/15 vs 2/9, p=0.04), with nine drug types successfully administered without maternal complications or death.
Patients with arrhythmias had a significantly higher rate of lower cardiac functional class (8/29, p=0.04) and polysplenia (4/29, p=0.04) compared to controls.
Pregnancies complicated by arrhythmias showed a significantly higher incidence of low-birthweight infants than control pregnancies (7/29, p=0.02).

Study Design

Type

Observational (n=56)

Multicenter

Yes

Structured PICO

Does the presence of arrhythmia during pregnancy in patients with repaired congenital heart disease worsen maternal and fetal outcomes?

Population

56 pregnant women (58 pregnancies) with repaired congenital heart disease, including 27 with arrhythmias and 29 matched controls without arrhythmias, evaluated retrospectively across 17 institutions.

Exposure

Presence of arrhythmia (supraventricular tachyarrhythmia, ventricular tachycardia, high-grade atrioventricular block, or sick sinus syndrome) during pregnancy

Comparator

No arrhythmia during pregnancy

Outcome

Maternal and fetal outcomes including maternal death, maternal complications, and incidence of low-birthweight infantshard clinical

Main Result

Absolute Event Rate: 24.1% vs 3.4%

p-value: p=0.02

Arrhythmias during pregnancy in patients with repaired congenital heart disease are associated with lower cardiac functional class, polysplenia, and an increased risk of delivering low-birthweight infants.

Limitations

Small number of patients limits the statistical power of the relationship between variables and arrhythmia.
Different cardiologists from different institutions had different approaches to arrhythmia treatment, so outcome measures of these regimens were not assessed.
Potential positive bias for the evaluation of the incidence of arrhythmia because the participating institutions specifically care for patients with CHD during pregnancy.

Cite This Study

Tateno et al. (2003) conducted an observational in Congenital heart disease during pregnancy (n=56). Arrhythmia during pregnancy vs. No arrhythmia during pregnancy was evaluated on Incidence of low-birthweight infants (p=0.02). Arrhythmias during pregnancy in women with repaired congenital heart disease were associated with a significantly higher incidence of low-birthweight infants compared to those without arrhythmias (24.1% vs 3.4%, p=0.02).

synapsesocial.com/papers/6a9199b2eb80182e01121fc1 https://doi.org/10.1253/circj.67.992

Topics

Congenital heart disease adults

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Implication

Arrhythmia in pregnant women with repaired CHD may signal higher low-birthweight risk; leaves open causality and need for prospective studies.

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

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

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

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider