Mitral valve prolapse: arrhythmic risk during pregnancy and postpartum
Language English Country Great Britain, England Media print
Document type Journal Article, Multicenter Study
Grant support
Slezak fund
288438 and #309762
Norwegian Research Council
PubMed
38740526
PubMed Central
PMC11129793
DOI
10.1093/eurheartj/ehae224
PII: 7671160
Knihovny.cz E-resources
- Keywords
- Arrhythmic mitral valve prolapse, Cardiomyopathy, Mitral annular disjunction, Pregnancy, Ventricular arrhythmia,
- MeSH
- Defibrillators, Implantable MeSH
- Adult MeSH
- Ventricular Fibrillation epidemiology etiology MeSH
- Incidence MeSH
- Pregnancy Complications, Cardiovascular * epidemiology MeSH
- Tachycardia, Ventricular epidemiology etiology MeSH
- Humans MeSH
- Postpartum Period MeSH
- Puerperal Disorders epidemiology etiology MeSH
- Mitral Valve Prolapse * complications epidemiology MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Arrhythmias, Cardiac epidemiology etiology MeSH
- Pregnancy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
BACKGROUND AND AIMS: Arrhythmic mitral valve prolapse (AMVP) is linked to life-threatening ventricular arrhythmias (VAs), and young women are considered at high risk. Cases of AMVP in women with malignant VA during pregnancy have emerged, but the arrhythmic risk during pregnancy is unknown. The authors aimed to describe features of women with high-risk AMVP who developed malignant VA during the perinatal period and to assess if pregnancy and the postpartum period were associated with a higher risk of malignant VA. METHODS: This retrospective international multi-centre case series included high-risk women with AMVP who experienced malignant VA and at least one pregnancy. Malignant VA included ventricular fibrillation, sustained ventricular tachycardia, or appropriate shock from an implantable cardioverter defibrillator. The authors compared the incidence of malignant VA in non-pregnant periods and perinatal period; the latter defined as occurring during pregnancy and within 6 months after delivery. RESULTS: The authors included 18 women with AMVP from 11 centres. During 7.5 (interquartile range 5.8-16.6) years of follow-up, 37 malignant VAs occurred, of which 18 were pregnancy related occurring in 13 (72%) unique patients. Pregnancy and 6 months after delivery showed increased incidence rate of malignant VA compared to the non-pregnancy period (univariate incidence rate ratio 2.66, 95% confidence interval 1.23-5.76). CONCLUSIONS: The perinatal period could impose increased risk of malignant VA in women with high-risk AMVP. The data may provide general guidance for pre-conception counselling and for nuanced shared decision-making between patients and clinicians.
Austin and Northern Health University of Melbourne Melbourne Australia
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Cardiology Karolinska University Hospital Stockholm Sweden
Department of Cardiology University Medical Centre Utrecht Utrecht The Netherlands
Department of Cardiovascular Medicine Mayo Clinic Rochester MN USA
Jesselson Integrated Heart Center Shaare Zedek Medical Center Jerusalem Israel
LTSI Rennes University Hospital Rennes France
Sorbonne Université AP HP Groupe Hospitalier Pitié Salpêtrière Paris France
doi: 10.1093/eurheartj/ehae246 PubMed
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