Arrhythmia risk and β-blocker therapy in pregnant women with long QT syndrome
| Autor: | Hideo Okamura, Hiroshi Watanabe, Akihiro Terasawa, Koko Asakura, Seiko Ohno, Jun Yoshimatsu, Hitoshi Mikami, Yosuke Fukushima, Ikutaro Nakajima, Heima Sakaguchi, Yoshimitsu Tsuzuki, Hiroko Goto, Koji Miyamoto, Hideki Itoh, Satoshi Yasuda, Yoshihiro Miyamoto, Mitsuru Wada, Takashi Noda, Sato Imashiro, Takaomi Minami, Kohei Ishibashi, Takeshi Aiba, Hideki Motomura, Yukiko Nakano, Takashi Akasaka, Nobue Yagihara, Kanae Hasegawa, Toshifumi Yamauchi, Chizuko Kamiya, Yoshiharu Ogawa, Wataru Shimizu, Kayo Ogino, Minoru Horie, Shiro Kamakura, Kengo Kusano, Isao Shiraishi, Aya Miyazaki |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty Long QT syndrome Adrenergic beta-Antagonists Pregnancy Complications Cardiovascular Increased heart rate 030204 cardiovascular system & hematology Abortion Electrocardiography 03 medical and health sciences 0302 clinical medicine Heart Rate Pregnancy Risk Factors medicine Fetal growth Humans 030212 general & internal medicine Retrospective Studies business.industry Significant difference medicine.disease Long QT Syndrome Early Diagnosis Treatment Outcome Tachycardia Ventricular Medical genetics Female Cardiology and Cardiovascular Medicine business Postpartum period |
| Zdroj: | Heart. 103:1374-1379 |
| ISSN: | 1468-201X 1355-6037 |
| DOI: | 10.1136/heartjnl-2016-310617 |
| Popis: | Background Pregnancy is one of the biggest concerns for women with long QT syndrome (LQTS). Objectives This study investigated pregnancy-related arrhythmic risk and the efficacy and safety of β-blocker therapy for lethal ventricular arrhythmias in pregnant women with LQTS (LQT-P) and their babies. Methods 136 pregnancies in 76 LQT-P (29±5 years old; 22 LQT1, 36 LQT2, one LQT3, and 17 genotype-unknown) were enrolled. We retrospectively analysed their clinical and electrophysiological characteristics and pregnancy outcomes in the presence (BB group: n=42) or absence of β-blocker therapy (non-BB group: n=94). Results All of the BB group had been diagnosed with LQTS with previous events, whereas 65% of the non-BB group had not been diagnosed at pregnancy. Pregnancy increased heart rate in the non-BB group; however, no significant difference was observed in QT and Tpeak-Tend intervals between the two groups. In the BB group, only two events occurred at postpartum, whereas 12 events occurred in the non-BB group during pregnancy (n=6) or postpartum period (n=6). The frequency of spontaneous abortion did not differ between the two groups. Fetal growth rate and proportion of infants with congenital malformation were similar between the two groups, but premature delivery and low birthweight infants were more common in those taking BB (OR 4.79, 95% CI 1.51 to 15.21 and OR 3.25, 95% CI 1.17 to 9.09, respectively). Conclusions Early diagnosis and β-blocker therapy for high-risk patients with LQTS are important for prevention of cardiac events during pregnancy and the postpartum period, and β-blocker therapy may be tolerated for babies in LQT-P cases. |
| Databáze: | OpenAIRE |
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