Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, the Netherlands.
JACC Clin Electrophysiol. 2019 Mar;5(3):387-394. doi: 10.1016/j.jacep.2018.10.019. Epub 2018 Dec 26.
This investigation was a retrospective study of catecholaminergic polymorphic ventricular tachycardia (CPVT) patients in Canada and the Netherlands to compare pregnancy, postpartum, and nonpregnant event rates.
CPVT is characterized by life-threatening arrhythmias during exertion or emotional stress. The arrhythmic risk in CPVT patients during pregnancy is unknown.
Baseline demographics, genetics, treatment, and pregnancy complications were reviewed. Event rate calculations assumed a 40-week pregnancy and 24-week postpartum period.
Ninety-six CPVT patients had 228 pregnancies (median 2 pregnancies per patient; range: 1 to 10; total: 175.4 pregnant patient-years). The median age of CPVT diagnosis was 40.7 years (range: 12 to 84 years), with a median follow-up of 2.9 years (range: 0 to 20 years; total 448.1 patient-years). Most patients had pregnancies before CPVT diagnosis (82%). Pregnancy and postpartum cardiac events included syncope (5%) and an aborted cardiac arrest (1%), which occurred in patients who were not taking beta-blockers. Other complications included miscarriages (13%) and intrauterine growth restriction (1 case). There were 6 cardiac events (6%) during the nonpregnant period. The pregnancy and postpartum event rates were 1.71 and 2.85 events per 100 patient-years, respectively, and the combined event rate during the pregnancy and postpartum period was 2.14 events per 100 patient-years. These rates were not different from the nonpregnant event rate (1.46 events per 100 patient-years).
The combined pregnancy and postpartum arrhythmic risk in CPVT patients was not elevated compared with the nonpregnant period. Most patients had pregnancies before diagnosis, and all patients with events were not taking beta-blockers at the time of the event.
本研究回顾性分析了加拿大和荷兰的儿茶酚胺多形性室性心动过速（CPVT）患者，比较了妊娠、产后和非妊娠期间的事件发生率。
CPVT 的特征是在运动或情绪压力下发生危及生命的心律失常。CPVT 患者在妊娠期间的心律失常风险尚不清楚。
回顾了患者的基线人口统计学、遗传学、治疗和妊娠并发症。通过假设妊娠 40 周和产后 24 周来计算事件发生率。
96 例 CPVT 患者共发生 228 次妊娠（中位数为每位患者 2 次妊娠；范围：1 至 10；总计：175.4 例妊娠患者年）。CPVT 诊断的中位年龄为 40.7 岁（范围：12 至 84 岁），中位随访时间为 2.9 年（范围：0 至 20 年；总计 448.1 例患者年）。大多数患者在 CPVT 诊断前就有妊娠（82%）。妊娠和产后的心脏事件包括晕厥（5%）和心搏骤停（1%），这些事件发生在未服用β受体阻滞剂的患者中。其他并发症包括流产（13%）和宫内生长受限（1 例）。非妊娠期间发生了 6 次心脏事件（6%）。妊娠和产后的事件发生率分别为每 100 例患者年 1.71 和 2.85 次，妊娠和产后期间的总事件发生率为每 100 例患者年 2.14 次。这些发生率与非妊娠期间的发生率（每 100 例患者年 1.46 次）无差异。
CPVT 患者妊娠和产后期间的心律失常风险与非妊娠期间无差异。大多数患者在诊断前就有妊娠，且所有发生事件的患者在事件发生时均未服用β受体阻滞剂。
