Li Jian-Ming, Nguyen Carol, Joglar Jose A, Hamdan Mohamed H, Page Richard L
Division of Cardiology, Department of Veterans Affairs Medical Center, University of Minnesota, Minneapolis, MN 55417, USA.
Clin Cardiol. 2008 Nov;31(11):538-41. doi: 10.1002/clc.20326.
Arrhythmias are reported during pregnancy, although hospitalization for these infrequent events is not fully characterized. The frequency and outcome of arrhythmias during pregnancy are unknown.
Between 1992 and 2000, there were 136,422 pregnancy-related admissions to Parkland Memorial Hospital (Dallas, TX, USA). Using the discharge diagnosis data bank and the International Classification of Disease, 9th revision, Clinical Modification (ICD-9-CM) coding system, we identified 226 admissions (218 patients) where cardiac arrhythmias and intrauterine pregnancy were both reported.
The most common rhythm disturbances during pregnancy were sinus tachycardia (ST), sinus bradycardia (SB), or sinus arrhythmia (SA) (104 episodes/100,000 pregnancies). This was followed by paroxysmal supraventricular tachycardia (PSVT) and premature beats, with a frequency of 24/100,000 and 33/100,000, respectively. Paroxysmal supraventricular tachycardia occurred most frequently in the third trimester or peripartum. All episodes terminated spontaneously or were safely terminated with medical therapy. Advanced heart block or lethal arrhythmias were exceedingly rare during pregnancy.
Most frequently reported cardiac arrhythmias in pregnancy are benign and do not require intervention. Supraventricular tachycardia (SVT), being one of the most common complicated cardiac arrhythmias during pregnancy, can be treated effectively and safely with standard medical therapy. Ventricular arrhythmias or high-degree atrioventricular block (AVB) during pregnancy are extremely rare. Cardiac arrest is also rare, and is often caused by a different etiology from the conventional ones for sudden cardiac death.
尽管孕期心律失常的住院情况尚未完全明确，但孕期心律失常的病例时有报道。孕期心律失常的发生频率及转归尚不清楚。
1992年至2000年间，美国得克萨斯州达拉斯市帕克兰纪念医院有136,422例与妊娠相关的住院病例。利用出院诊断数据库及国际疾病分类第九版临床修订本（ICD-9-CM）编码系统，我们确定了226例住院病例（218名患者），这些病例均报告了心律失常及宫内妊娠。
孕期最常见的节律紊乱为窦性心动过速（ST）、窦性心动过缓（SB）或窦性心律失常（SA）（每100,000次妊娠中有104例发作）。其次是阵发性室上性心动过速（PSVT）和早搏，发生率分别为每100,000次妊娠中有24例和33例。阵发性室上性心动过速最常发生在孕晚期或围产期。所有发作均自行终止或经药物治疗安全终止。孕期高级别心脏传导阻滞或致命性心律失常极为罕见。
孕期最常报告的心律失常多为良性，无需干预。室上性心动过速（SVT）作为孕期最常见的复杂心律失常之一，可通过标准药物治疗有效且安全地进行治疗。孕期室性心律失常或高度房室传导阻滞（AVB）极为罕见。心脏骤停也很罕见，其病因通常与传统的心源性猝死病因不同。
