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Herzschrittmachertherapie + Elektrophysiologie

Erschienen in:

10.05.2021 | Schwerpunkt

Pregnancy in patients with implantable cardiac defibrillators

verfasst von: Geoffrey R. Wong, MBBS PhD, Megan Ang, MBBS, Jasveer Jayarajan, MBBS MClinEd, Fiona Walker, MD, Professor Pier D. Lambiase, BMBCh PhD

Erschienen in: Herzschrittmachertherapie + Elektrophysiologie | Ausgabe 2/2021

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Abstract

The number of patients of reproductive age with inherited and congenital heart disease receiving implantable cardiac defibrillators (ICD) is steadily increasing. Safely and effectively coordinating pregnancy in this high-risk cohort is important to optimise maternal–foetal outcomes. As members of the multidisciplinary team caring for pregnant patients with indications for ICD, cardiologists and electrophysiologists should be aware of the considerations and nuances involved in managing these patients. This article reviews the pathophysiology of arrhythmias, ICD implantation considerations, novel minimal fluoroscopy techniques and subcutaneous ICD. In addition, antenatal and device management during pregnancy and delivery are discussed.

Abello M, Peinado R, Merino JL, Gnoatto M, Mateos M, Silvestre J, Dominguez JL (2003) Cardioverter defibrillator implantation in a pregnant woman guided with transesophageal echocardiography. Pacing Clin Electrophysiol 26:1913–1914PubMedCrossRef

Ahmed A, Phillips JR (2016) Teenage pregnancy with catecholaminergic polymorphic ventricular tachycardia and documented ICD discharges. Clin Case Rep 4:361–365PubMedPubMedCentralCrossRef

American College of Obstetricians and Gynecologists’ Presidential Task Force on Pregnancy and Heart Disease and Committee on Practice Bulletins—Obstetrics (2019) ACOG Practice Bulletin no. 212: pregnancy and heart disease. Obstet Gynecol Clin North Am 133:e320–e356

Ananwattanasuk T, Tanawuttiwat T, Chokesuwattanaskul R, Lathkar-Pradhan S, Barham W, Oral H, Thakur RK, Jongnarangsin K (2020) Programming implantable cardioverter-defibrillator in primary prevention: guideline concordance and outcomes. Heart Rhythm 17:1101–1106PubMedCrossRef

Barnes EJ, Eben F, Patterson D (2002) Direct current cardioversion during pregnancy should be performed with facilities available for fetal monitoring and emergency caesarean section. BJOG 109:1406–1407PubMedCrossRef

Berul CI, Van Hare GF, Kertesz NJ, Dubin AM, Cecchin F, Collins KK, Cannon BC, Alexander ME, Triedman JK, Walsh EP, Friedman RA (2008) Results of a multicenter retrospective implantable cardioverter-defibrillator registry of pediatric and congenital heart disease patients. J Am Coll Cardiol 51:1685–1691PubMedCrossRef

Best PJ, Skelding KA, Mehran R, Chieffo A, Kunadian V, Madan M, Mikhail GW, Mauri F, Takahashi S, Honye J, Hernandez-Antolin R, Weiner BH (2011) SCAI consensus document on occupational radiation exposure to the pregnant cardiologist and technical personnel. EuroIntervention 6:866–874PubMedCrossRef

Bonini W, Botto GL, Broffoni T, Dondina C (2000) Pregnancy with an ICD and a documented ICD discharge. Europace 2:87–90PubMedCrossRef

Boule S, Ovart L, Marquie C, Botcherby E, Klug D, Kouakam C, Brigadeau F, Guedon-Moreau L, Wissocque L, Meurice J, Lacroix D, Kacet S (2014) Pregnancy in women with an implantable cardioverter-defibrillator: is it safe? Europace 16:1587–1594PubMedCrossRef

10.

Brown O, Davidson N, Palmer J (2001) Cardioversion in the third trimester of pregnancy. Aust N Z J Obstet Gynaecol 41:241–242PubMedCrossRef

11.

Castrejon-Castrejon S, Perez-Silva A, Gonzalez-Villegas E, Al-Razzo O, Silvestre J, Doiny D, Estrada-Mucci A, Filgueiras-Rama D, Ortega-Molina M, Lopez-Sendon JL, Merino JL (2013) Implantation of cardioverter defibrillators with minimal fluoroscopy using a three-dimensional navigation system: a feasibility study. Europace 15:1763–1770PubMedCrossRef

12.

Cox JL, Gardner MJ (1993) Treatment of cardiac arrhythmias during pregnancy. Prog Cardiovasc Dis 36:137–178PubMedCrossRef

13.

DeSilva RA, Graboys TB, Podrid PJ, Lown B (1980) Cardioversion and defibrillation. Am Heart J 100:881–895PubMedCrossRef

14.

Donnelly P, Pal N, Herity NA (2007) Perioperative management of patients with implantable cardioverter defibrillators. Ulster Med J 76:66–67PubMedPubMedCentral

15.

Enriquez AD, Economy KE, Tedrow UB (2014) Contemporary management of arrhythmias during pregnancy. Circ Arrhythm Electrophysiol 7:961–967PubMedCrossRef

16.

Ertekin E, van Hagen IM, Salam AM, Ruys TP, Johnson MR, Popelova J, Parsonage WA, Ashour Z, Shotan A, Oliver JM, Veldtman GR, Hall R, Roos-Hesselink JW (2016) Ventricular tachyarrhythmia during pregnancy in women with heart disease: Data from the ROPAC, a registry from the European Society of Cardiology. Int J Cardiol 220:131–136PubMedCrossRef

17.

Esmaiel A, Hassan J, Blenkhorn F, Mardigyan V (2016) The use of ultrasound to improve axillary vein access and minimize complications during pacemaker implantation. Pacing Clin Electrophysiol 39:478–482PubMedCrossRef

18.

Friday KP, Moak JP, Fries MH, Iqbal SN (2015) Catecholaminergic ventricular tachycardia, pregnancy and teenager: are they compatible? Pediatr Cardiol 36:1542–1547PubMedCrossRef

19.

Healey JS, Hohnloser SH, Glikson M, Neuzner J, Mabo P, Vinolas X, Kautzner J, O’Hara G, VanErven L, Gadler F, Pogue J, Appl U, Gilkerson J, Pochet T, Stein KM, Merkely B, Chrolavicius S, Meeks B, Foldesi C, Thibault B, Connolly SJ (2015) Cardioverter defibrillator implantation without induction of ventricular fibrillation: a single-blind, non-inferiority, randomised controlled trial (SIMPLE). Lancet 385:785–791PubMedCrossRef

20.

Isaacs JD, Mulholland DH, Hess LW, Allbert JR, Martin RW (1993) Pregnancy in a woman with an automatic implantable cardioverter-defibrillator. A case report. J Reprod Med 38:487–488PubMed

21.

Jeejeebhoy FM, Zelop CM, Lipman S, Carvalho B, Joglar J, Mhyre JM, Katz VL, Lapinsky SE, Einav S, Warnes CA, Page RL, Griffin RE, Jain A, Dainty KN, Arafeh J, Windrim R, Koren G, Callaway CW (2015) Cardiac arrest in pregnancy: a scientific statement from the American Heart Association. Circulation 132:1747–1773PubMedCrossRef

22.

Lanssens D, Smeets CJP, Vandervoort P, Grieten L, Gyselaers W (2020) Intrathoracic fluid changes from preconception to postpartum as measured by bio-impedance monitoring. J Matern Fetal Neonatal Med 33:1625–1627PubMedCrossRef

23.

Link MS, Laidlaw D, Polonsky B, Zareba W, McNitt S, Gear K, Marcus F, Estes NA 3rd (2014) Ventricular arrhythmias in the North American multidisciplinary study of ARVC: predictors, characteristics, and treatment. J Am Coll Cardiol 64:119–125PubMedPubMedCentralCrossRef

24.

Maisel WH, Moynahan M, Zuckerman BD, Gross TP, Tovar OH, Tillman DB, Schultz DB (2006) Pacemaker and ICD generator malfunctions: analysis of Food and Drug Administration annual reports. JAMA 295:1901–1906PubMedCrossRef

25.

Miyoshi T, Kamiya CA, Katsuragi S, Ueda H, Kobayashi Y, Horiuchi C, Yamanaka K, Neki R, Yoshimatsu J, Ikeda T, Yamada Y, Okamura H, Noda T, Shimizu W (2013) Safety and efficacy of implantable cardioverter-defibrillator during pregnancy and after delivery. Circ J 77:1166–1170PubMedCrossRef

26.

Natale A, Davidson T, Geiger MJ, Newby K (1997) Implantable cardioverter-defibrillators and pregnancy: a safe combination? Circulation 96:2808–2812PubMedCrossRef

27.

Priori SG, Blomstrom-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekval TM, Spaulding C, Van Veldhuisen DJ (2015) 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J 36:2793–2867PubMedCrossRef

28.

Quast ABE, Baalman SWE, Betts TR, Boersma LVA, Bonnemeier H, Boveda S, Brouwer TF, Burke MC, Delnoy P, El-Chami M, Kuschyk J, Lambiase P, Marquie C, Miller MA, Smeding L, Wilde AAM, Knops RE (2019) Rationale and design of the PRAETORIAN-DFT trial: A prospective randomized CompArative trial of SubcutanEous ImplanTable CardiOverter-DefibrillatoR ImplANtation with and without DeFibrillation testing. Am Heart J 214:167–174PubMedCrossRef

29.

Quast ABE, Baalman SWE, Brouwer TF, Smeding L, Wilde AAM, Burke MC, Knops RE (2019) A novel tool to evaluate the implant position and predict defibrillation success of the subcutaneous implantable cardioverter-defibrillator: the PRAETORIAN score. Heart Rhythm 16:403–410PubMedCrossRef

30.

Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomstrom-Lundqvist C, Cifkova R, De Bonis M, Iung B, Johnson MR, Kintscher U, Kranke P, Lang IM, Morais J, Pieper PG, Presbitero P, Price S, Rosano GMC, Seeland U, Simoncini T, Swan L, Warnes CA (2018) 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J 39:3165–3241PubMedCrossRef

31.

Roston TM, Jones K, Hawkins NM, Bos JM, Schwartz PJ, Perry F, Ackerman MJ, Laksman ZWM, Kaul P, Lieve KVV, Atallah J, Krahn AD, Sanatani S (2018) Implantable cardioverter-defibrillator use in catecholaminergic polymorphic ventricular tachycardia: A systematic review. Heart Rhythm 15:1791–1799PubMedCrossRef

32.

Roston TM, van der Werf C, Cheung CC, Grewal J, Davies B, Wilde AAM, Krahn AD (2020) Caring for the pregnant woman with an inherited arrhythmia syndrome. Heart Rhythm 17:341–348PubMedCrossRef

33.

Schuler PK, Herrey A, Wade A, Brooks R, Peebles D, Lambiase P, Walker F (2012) Pregnancy outcome and management of women with an implantable cardioverter defibrillator: a single centre experience. Europace 14:1740–1745PubMedCrossRef

34.

Siu SC, Sermer M, Colman JM, Alvarez AN, Mercier LA, Morton BC, Kells CM, Bergin ML, Kiess MC, Marcotte F, Taylor DA, Gordon EP, Spears JC, Tam JW, Amankwah KS, Smallhorn JF, Farine D, Sorensen S (2001) Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation 104:515–521PubMedCrossRef

35.

Strewe C, Fichtner S (2015) Completely subcutaneous implantable cardioverter defibrillator: care of S‑ICD wearers during childbirth. Anaesthesist 64:843–845PubMedCrossRef

36.

Tateno S, Niwa K, Nakazawa M, Akagi T, Shinohara T, Yasuda T (2003) Arrhythmia and conduction disturbances in patients with congenital heart disease during pregnancy: multicenter study. Circ J 67:992–997PubMedCrossRef

37.

Thomas HT, A, Plummer C (2019) British Heart Rhythm Society Guidelines for the management of patients with cardiac implantable electronic devices (CIEDs) around the time of surgery. https://bhrs.com/wp-content/uploads/2019/05/Revised-guideline-CIED-and-surgery-Feb-19.pdf. Accessed 16 Dec 2020

38.

Tromp CH, Nanne AC, Pernet PJ, Tukkie R, Bolte AC (2011) Electrical cardioversion during pregnancy: safe or not? Neth Heart J 19:134–136PubMedPubMedCentralCrossRef

39.

Wieseler KM, Bhargava P, Kanal KM, Vaidya S, Stewart BK, Dighe MK (2010) Imaging in pregnant patients: examination appropriateness. Radiographics 30:1215–1229 (discussion 1230–1213)PubMedCrossRef

40.

Wilkoff BL, Fauchier L, Stiles MK, Morillo CA, Al-Khatib SM, Almendral J, Aguinaga L, Berger RD, Cuesta A, Daubert JP, Dubner S, Ellenbogen KA, Estes NA 3rd, Fenelon G, Garcia FC, Gasparini M, Haines DE, Healey JS, Hurtwitz JL, Keegan R, Kolb C, Kuck KH, Marinskis G, Martinelli M, McGuire M, Molina LG, Okumura K, Proclemer A, Russo AM, Singh JP, Swerdlow CD, Teo WS, Uribe W, Viskin S, Wang CC, Zhang S, Document R (2016) 2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing. Europace 18:159–183PubMedCrossRef

41.

Winter J, Siekiera M, Shin DI, Meyer C, Kropil P, Clahsen H, O’Connor S (2017) Intermuscular technique for implantation of the subcutaneous implantable cardioverter defibrillator: long-term performance and complications. Europace 19:2036–2041PubMedCrossRef

42.

Yang B, Ren BX, Tang FR (2017) Prenatal irradiation-induced brain neuropathology and cognitive impairment. Brain Dev 39:10–22PubMedCrossRef

43.

Yano M, Nishida Y, Kai K, Ishii T, Takahashi N, Narahara H (2017) Long QT syndrome in pregnancy: a successful case of ICD implantation during the prenatal period. J Obstet Gynaecol 37:531–532PubMedCrossRef

Titel: Pregnancy in patients with implantable cardiac defibrillators
verfasst von: Geoffrey R. Wong, MBBS PhD
Megan Ang, MBBS
Jasveer Jayarajan, MBBS MClinEd
Fiona Walker, MD
Professor Pier D. Lambiase, BMBCh PhD
Publikationsdatum: 10.05.2021
Verlag: Springer Medizin
Erschienen in: Herzschrittmachertherapie + Elektrophysiologie / Ausgabe 2/2021
Print ISSN: 0938-7412
Elektronische ISSN: 1435-1544
DOI: https://doi.org/10.1007/s00399-021-00750-x

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