Successful Electrical Cardioversion in Late Pregnancy Woman With Supraventricular Tachycardia
A Case Report
Abstract
Background: Pregnancy, precipitate cardiac arrhythmia, and supraventricular tachycardia (SVT) are some most frequent and sustained arrhythmias in pregnancy. In general, the pharmacological approach in pregnant patient is similar to that in the non-pregnant patient. However, fetal safety becomes a special consideration before administering the therapy.
Case Presentation: We reported a 34-year-old female G3P2A0 with 35 weeks of gestation who came to the emergency department with sudden onset palpitations within 2 hours before admission. She had no prior history of any major medical illness. The clinical examination revealed that the patient had a regular pulse rate of 198/minute, and the blood pressure was 80/50 mmHg. The electrocardiogram showed the presence of SVT. Synchronized cardioversion with 50 joules was performed. The patient’s rhythm was converted to sinus tachycardia with a pulse rate of 120/minute and blood pressure was 90/60 mmHg. The patient was admitted to ICCU immediately after cardioversion and discharged from the hospital without any adverse effects after two days of monitoring.
Conclusion: SVT is arrhythmia condition that is often found in pregnant women. In an unstable SVT condition, cardioversion is the first general action that is safe to be performed on the mother and the fetus. It must have strict observation before and after cardioversion to monitor whether there was a problem with the fetus or not.
Downloads
References
2. Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ, et al. 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation [Internet]. 2016 Apr 5 [cited 2022 Jan 17];133(14). Available from: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000310
3. Orejarena LA, Vidaillet H, DeStefano F, Nordstrom DL, Vierkant RA, Smith PN, et al. Paroxysmal Supraventricular Tachycardia in the General Population. J Am Coll Cardiol. 1998 Jan;31(1):150–7.
4. Silversides CK, Harris L, Haberer K, Sermer M, Colman JM, Siu SC. Recurrence Rates of Arrhythmias During Pregnancy in Women With Previous Tachyarrhythmia and Impact on Fetal and Neonatal Outcomes. Am J Cardiol. 2006 Apr;97(8):1206–12.
5. Ghosh N, Luk A, Derzko C, Dorian P, Chow C-M. The Acute Treatment of Maternal Supraventricular Tachycardias During Pregnancy: A Review of the Literature. J Obstet Gynaecol Can. 2011 Jan;33(1):17–23.
6. Moore JS, Teefey P, Rao K, Berlowitz MS, Chae SH, Yankowitz J. Maternal Arrhythmia: A Case Report and Review of the Literature. Obstet Gynecol Surv. 2012 May;67(5):298–312.
7. Wang Y-C, Chen C-H, Su H-Y, Yu M-H. The impact of maternal cardioversion on fetal hemodynamics. Eur J Obstet Gynecol Reprod Biol. 2006 Jun;126(2):268–9.
8. Laksman Z, Harris L, Silversides CK. Cardiac arrhythmias during pregnancy: A clinical approach. Fetal Matern Med Rev. 2011 May;22(2):123–43.
9. Enriquez AD, Economy KE, Tedrow UB. Contemporary Management of Arrhythmias During Pregnancy. Circ Arrhythm Electrophysiol. 2014 Oct;7(5):961–7.
10. Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomström-Lundqvist C, Cífková R, De Bonis M, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 2018 Sep 7;39(34):3165–241.
11. Williams DS, Mikhova K, Sodhi S. Arrhythmias and Pregnancy: Management of Preexisting and New-Onset Maternal Arrhythmias. Cardiol Clin. 2021 Feb;39(1):67–75.
12. Ibetoh CN, Stratulat E, Liu F, Wuni GY, Bahuva R, Shafiq MA, et al. Supraventricular Tachycardia in Pregnancy: Gestational and Labor Differences in Treatment. Cureus. 2021 Oct;13(10):e18479.
13. Cordina R, McGuire MA. Maternal cardiac arrhythmias during pregnancy and lactation. Obstet Med. 2010 Mar;3(1):8–16.
14. Tromp CHN, Nanne ACM, Pernet PJM, Tukkie R, Bolte AC. Electrical cardioversion during pregnancy: safe or not? Neth Heart J Mon J Neth Soc Cardiol Neth Heart Found. 2011 Mar;19(3):134–6.
Full Text (PDF) downloads: 95
Copyright (c) 2023 Indonesian Journal of Cardiology
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).