Maternal focal atrial tachycardia during pregnancy: A systematic review.
atrial tachycardia
catheter ablation
fluoroscopy
pregnancy
supraventricular tachycardia
systematic review
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
01
05
2020
revised:
19
06
2020
accepted:
25
08
2020
pubmed:
9
9
2020
medline:
29
7
2021
entrez:
8
9
2020
Statut:
ppublish
Résumé
The presentation and optimal management of maternal focal atrial tachycardia (AT) during pregnancy are unknown. The objective of this study is to conduct a comprehensive summary of the existing evidence. A systematic review of all reported cases of maternal focal AT during pregnancy was performed. The primary search queried PubMed using the MeSH terms "supraventricular tachycardia" and "pregnancy." A stepwise ancillary search included article bibliographies, citations listed by the Google internet search engine, and PubMed using the MeSH terms "atrial tachycardia" and "pregnancy." In total, 28 citations that described 32 patients were retrieved. A case from our institution was added. Detailed information was available for 30 patients. Clinical characteristics at presentation included a mean ± standard deviation of 28.3 ± 5.7 years for maternal age and 24.6 ± 7.7 weeks for gestation age. Suspected tachycardia-induced cardiomyopathy was present in 20 of 30 (67%) patients and left ventricular ejection fraction improved in 15 of 15 (100%) patients with follow-up measurements. Medication failure was common. Focal AT resolved spontaneously after delivery in eight of nine (89%) patients treated with only medications. Automaticity was suggested by discrete electrograms at sites of origin and lack of reported inducibility and termination with programmed stimulation in all patients who underwent electrophysiology studies. There were nine cases of successful catheter ablation with zero fluoroscopy since 2010. Automaticity is the dominant mechanism for patients with maternal focal AT during pregnancy. Catheter ablation with zero fluoroscopy is an emerging therapy for medically refractory cases.
Identifiants
pubmed: 32897619
doi: 10.1111/jce.14738
pmc: PMC7719585
mid: NIHMS1640853
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2982-2997Subventions
Organisme : NICHD NIH HHS
ID : K12 HD043441
Pays : United States
Informations de copyright
© 2020 Wiley Periodicals LLC.
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