OBJECTIVES: To describe the incidence, onset, predictors and outcome of ventricular tachyarrhythmia (VTA) in pregnant women with heart disease. BACKGROUND: VTA during pregnancy will cause maternal morbidity and even mortality and will have impact on fetal outcome. Insufficient data exist on the incidence and outcome of VTA in pregnancy. METHODS AND RESULTS: From January 2007 up to October 2013, 99 hospitals in 39 countries enrolled 2966 pregnancies in women with structural heart disease. Forty-two women (1.4%) developed clinically relevant VTA during pregnancy, which occurred mainly in the third trimester (48%). NYHA class >1 before pregnancy was an independent predictor for VTA. Heart failure during pregnancy was more common in women with VTA than in women without VTA (24% vs. 12%, p=0.03) and maternal mortality was respectively 2.4% and 0.3% (p=0.15). More women with VTA delivered by Cesarean section than women without VTA (68% vs. 47%, p=0.01). Neonatal death, preterm birth (<37weeks), low birthweight (<2500g) and Apgar score <7 occurred more often in women with VTA (4.8% vs. 0.3%, p=0.01; 36% vs. 16%, p=0.001; 33% vs. 15%, p=0.001 and 25% vs. 7.3%, p=0.001, respectively). CONCLUSIONS: VTA occurred in 1.4% of pregnant women with cardiovascular disease, mainly in the third trimester, and was associated with heart failure during pregnancy. NYHA class before pregnancy was predictive. VTA during pregnancy had clear impact on fetal outcome.

Adolescent and Adult Congenital Heart Program Cincinnati Children's Hospital Cincinnati United States

Adult Congenital Heart Disease Unit La Paz University Hospital Madrid Spain

Cairo University Cairo Egypt

Erasmus University Medical Center Rotterdam The Netherlands

Erasmus University Medical Center Rotterdam The Netherlands; Fellow of the European Society of Cardiology Sophia Antipolis Cedex France

Hamad General Hospital Hamad Medical Corporation Doha Qatar

Hillel Yaffe Medical Center Hadera Israel

Hospital Na Homolce and Pediatric Heart Center University Hospital Motol Prague Czech Republic

Imperial College School of Medicine Chelsea and Westminster Hospital London United Kingdom

Norwich Medical School University of East Anglia Norwich United Kingdom

Royal Brisbane and Women's Hospital Herston Australia

Int J Cardiol. 2017 Apr 1;232:348. doi: 10.1016/j.ijcard.2017.01.077. PubMed

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