1Cardiology, Zevoulon Medical Center, Kiriat Bialik 2Gynecology, Zevoulon Medical Center, Kiriat Bialik 3Cardiology, Carmel Medical Center, Haifa 4Gynecology, Carmel Medical Center, Haifa
During the last 10 years , we have encountered with 123 pregnant women and 188 pregnancies of women who visited our cardiac problems of pregnancy clinic for cardiac causes. Mean age 26.8 years. Out of the 188 pregnancies, 50 of them (26.6%) visited our clinic for syncope and arrhythmia. Analyzing this group of syncope and arrhythmia-13 pregnancies (26%) were with recurrent supraventricular tachycardia during pregnancy treated with beta blockers according to the freguency of the episodes and with intravenous adenosine during the episode.10 of these pregnancies were delivered spontaneously at term,2 delivered preterm with cesarean section and one ended at 11 weeks for anencephallus.No maternal complications were noticed.10 pregnancies (20%) were with recurrent syncope-8 of them with reflex mediated syncope ,1 with orthostatic hypotension and 1 with postural orthostatic tachycardia syndrome .All of them were conducted how to behave during pregnancy and all of them successfully completed pregnancy with spontaneous delivery and without any maternal complications. 10 pregnancies (20%) were with wolf Parkinson white syndrome during pregnancy -7 of them delivered spontaneously and 3 with cesarean section .all of them at term and no maternal complications observed.6 pregnancies (12%) were with multiple ventricular premature complexes-all of them deliveres spontaneously without maternal complication.4 pregnancies (8%) were with pacemakers for complete atrioventricular block – 2 of them deliverd with cesarean section and 2 with vacuum without any complications.2 pregnancies (4%) were with implantable defibrillators for long QT syndrome – Both deliverd spontaneously at term and without any complications.2 pregnancies (4%) were with paroxysmal atrial tachycardia who deliverd spontaneously at term without complications and 2 other (4%) were with suspected Brugada syndrome who deliverd at term without complications. Most of the maternal arrhythmias were abolished with beta blockade without deleterious effect to the fetus. In a minority of the arrhythmias there was a need for class 1c antiarrythmic drugs such as Flecainide and for sotalol in order to abolish the arrhythmia. Conclusion : Based on our observation , Pregnant women with syncope and arrhythmias can safely complete pregnancy if they desire to do so.
