The Grown Up Congenital Heart Disease Unit, The Heart Hospital, University College London Hospitals (UCLH) NHS Trust, London, UK.
Europace. 2012 Dec;14(12):1740-5. doi: 10.1093/europace/eus172. Epub 2012 Jun 27.
With improved survival of patients with congenital and inherited heart disease, there is now a younger cohort of patients with an implantable cardioverter defibrillator (ICD) for the prevention and treatment of ventricular dysrrhythmias. Young women with such disorders often wish to embark on pregnancy, but pregnancy outcome data for this group is sparse. We therefore evaluated pregnancy outcome in patients with heart disease and an ICD in situ.
A retrospective analysis was performed on all women with an ICD in situ, who had pregnancy care provided by the specialist maternal cardiology service at University College London Hospitals. Data for 19 pregnancies in 14 women were collected. The underlying cardiac diagnoses were congenital heart disease (one), familial hypertrophic cardiomyopathy (eight), familial dilated cardiomyopathy (one), inherited long QT syndrome (one), and idiopathic cardiac arrest (one). Three women had moderate impairment of the left ventricular systolic function (ejection fraction <45%), in the remainder it was normal. Nine ICD implants were for primary prevention of sudden cardiac death (64%) and five for secondary prevention (36%). Of the 19 pregnancies, 18 continued beyond 24 weeks gestation with 18 live births. In eight pregnancies there were medical or device-related complications (42.9%) as follows: arrhythmias (four) (21.1%), heart failure (two) (9.1%), ICD shocks (one) (5.3%), atrial lead fracture (one) (5.3%), and lead-related thrombus (one) (5.3%). There were no inappropriate device shocks or therapies.
Women with heart disease and an ICD implant can have a good outcome during pregnancy but medical and device complications are not uncommon.
随着先天性和遗传性心脏病患者生存率的提高，现在有越来越多的年轻患者需要植入式心脏复律除颤器（ICD）来预防和治疗室性心律失常。患有此类疾病的年轻女性通常希望怀孕，但针对该人群的妊娠结局数据很少。因此，我们评估了患有心脏病和体内 ICD 的患者的妊娠结局。
对在伦敦大学学院医院接受专科母胎心脏病学服务妊娠护理的所有体内 ICD 患者进行了回顾性分析。共收集了 14 名女性的 19 例妊娠数据。潜在的心脏诊断包括先天性心脏病（1 例）、家族性肥厚型心肌病（8 例）、家族性扩张型心肌病（1 例）、遗传性长 QT 综合征（1 例）和特发性心脏骤停（1 例）。有 3 名女性左心室收缩功能中度受损（射血分数<45%），其余女性正常。9 例 ICD 植入是为了预防心脏性猝死（64%），5 例是为了二级预防（36%）。在 19 例妊娠中，有 18 例妊娠超过 24 周，有 18 例活产。在 8 例妊娠中出现了与医疗或器械相关的并发症（42.9%），包括心律失常（4 例）（21.1%）、心力衰竭（2 例）（9.1%）、ICD 电击（1 例）（5.3%）、心房导联断裂（1 例）（5.3%）和导联相关血栓（1 例）（5.3%）。没有发生不适当的器械电击或治疗。
患有心脏病和体内 ICD 植入的女性在怀孕期间可以有良好的结局，但医疗和器械并发症并不少见。
