Muscalu Oana, Tudorache Dragos, Mihai Bianca-Margareta, Vladareanu Ioana Teodora, Bohiltea Roxana Elena
Department of Cardiology, Colentina Clinical Hostpital, Bucharest, Romania.
Department of Obstetrics and Gynecology, Elias University Emergency Hospital, Bucharest, Romania.
Maedica (Bucur). 2021 Dec;16(4):729-733. doi: 10.26574/maedica.2020.16.4.729.
Implantable cardiac devices represent the first line treatment option used not only for secondary prevention of sudden cardiac death but also for primary prevention in patients with cardiac pathologies considered at risk of sudden cardiac death caused by ventricular tachycardia or ventricular fibrillation. The number of women with implantable cardiac devices reaching child bearing age is expected to increase more and more in the next years. Despite this tendency, there are only a few reported cases of pregnancies in implantable cardiac defibrillator carriers, leading to insufficient evidence and clear guideline recommendations on how to manage and monitor pregnancy in patients with this type of cardiac pathology. Closely monitoring within a multidisciplinary team consisting of an obstretician, electrophysiologist and anesthesiologist is required for this group of pregnant patients in order to achieve the best maternal and neonatal results. The present study describes the case of succesful outcome in a 27-year-old implantable cardiac defibrillator carrier implanted after an aborted cardiac arrest and reccurent polymorphic ventricular tachycardia due to myocarditis eight years prior to pregnancy, with an aim to emphasize the monitoring particularities and management during pregnancy.
植入式心脏设备是一线治疗选择，不仅用于心脏性猝死的二级预防，还用于患有被认为有因室性心动过速或心室颤动导致心脏性猝死风险的心脏疾病患者的一级预防。预计在未来几年，达到生育年龄的植入式心脏设备女性患者数量将越来越多。尽管有这种趋势，但植入式心脏除颤器携带者的妊娠报告病例很少，导致关于如何管理和监测这类心脏疾病患者妊娠的证据不足，也缺乏明确的指南建议。为了实现最佳的母婴结局，这类孕妇需要在由产科医生、电生理学家和麻醉师组成的多学科团队中进行密切监测。本研究描述了一名27岁植入式心脏除颤器携带者成功妊娠的病例，该携带者在妊娠前八年因心肌炎发生心脏骤停和复发性多形性室性心动过速后植入了除颤器，旨在强调妊娠期间的监测特点和管理。
