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Management of complete heart block during pregnancy.
J Obstet Gynaecol Res. 2013 Feb; 39(2):588-91.JO

Abstract

A 22-year-old second gravida presented to the antenatal clinic at 28 weeks of gestation with frequent fainting attacks (2-3 episodes/day), palpitations and dyspnea (New York Heart Association Functional Classification II). Her pulse rate was 40 b.p.m. A 12-lead electrocardiogram and 24-h Holter revealed complete heart block. A transvenous permanent pacemaker (ventricular demand rate-responsive), paced at a rate of 60 pulses/min, was successfully implanted. A multidisciplinary approach was taken and the patient delivered a healthy baby boy of 2.8 kg at 38 weeks. She remained asymptomatic and was discharged in good condition. Management varies from expectant management to temporary pacemaker insertion to permanent pacing during pregnancy. In a young patient with sinus bradycardia, the primary criterion for a pacemaker is the concurrent observation of a symptom (e.g., syncope) with bradycardia (e.g., heart rate 35-40 b.p.m. or asystole for 3 s). Symptomatic pregnant women should always be counseled for a permanent pacemaker.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Dhiman N
Obstetrics and Gynaecology Department, Safdarjung Hospital, New Delhi, India. nitti929@gmail.com; nitti_929@yahoo.co.in
Sarda N
No affiliation info available
Arora R
No affiliation info available

MeSH

AdultFemaleHeart BlockHumansPacemaker, ArtificialPregnancyPregnancy Complications, CardiovascularPregnancy Trimester, SecondSeverity of Illness IndexTerm BirthTreatment OutcomeYoung Adult

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

23006136

Citation

Dhiman, Niharika, et al. "Management of Complete Heart Block During Pregnancy." The Journal of Obstetrics and Gynaecology Research, vol. 39, no. 2, 2013, pp. 588-91.
Dhiman N, Sarda N, Arora R. Management of complete heart block during pregnancy. J Obstet Gynaecol Res. 2013;39(2):588-91.
Dhiman, N., Sarda, N., & Arora, R. (2013). Management of complete heart block during pregnancy. The Journal of Obstetrics and Gynaecology Research, 39(2), 588-91. https://doi.org/10.1111/j.1447-0756.2012.01983.x
Dhiman N, Sarda N, Arora R. Management of Complete Heart Block During Pregnancy. J Obstet Gynaecol Res. 2013;39(2):588-91. PubMed PMID: 23006136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of complete heart block during pregnancy. AU - Dhiman,Niharika, AU - Sarda,Nivedita, AU - Arora,Renu, Y1 - 2012/09/25/ PY - 2012/9/26/entrez PY - 2012/9/26/pubmed PY - 2013/11/19/medline SP - 588 EP - 91 JF - The journal of obstetrics and gynaecology research JO - J Obstet Gynaecol Res VL - 39 IS - 2 N2 - A 22-year-old second gravida presented to the antenatal clinic at 28 weeks of gestation with frequent fainting attacks (2-3 episodes/day), palpitations and dyspnea (New York Heart Association Functional Classification II). Her pulse rate was 40 b.p.m. A 12-lead electrocardiogram and 24-h Holter revealed complete heart block. A transvenous permanent pacemaker (ventricular demand rate-responsive), paced at a rate of 60 pulses/min, was successfully implanted. A multidisciplinary approach was taken and the patient delivered a healthy baby boy of 2.8 kg at 38 weeks. She remained asymptomatic and was discharged in good condition. Management varies from expectant management to temporary pacemaker insertion to permanent pacing during pregnancy. In a young patient with sinus bradycardia, the primary criterion for a pacemaker is the concurrent observation of a symptom (e.g., syncope) with bradycardia (e.g., heart rate 35-40 b.p.m. or asystole for 3 s). Symptomatic pregnant women should always be counseled for a permanent pacemaker. SN - 1447-0756 UR - https://www.unboundmedicine.com/medline/citation/23006136/Management_of_complete_heart_block_during_pregnancy_ DB - PRIME DP - Unbound Medicine ER -