METHODS: A prospective cohort study from the Colombian Registry of Pregnancy and Cardiovascular Disease was carried out from 2016 to 2019. All patients with tachyarrhythmia or bradyarrhythmia and a minimum follow-up of six months after delivery were included. The primary outcome was a composite of cardiac events defined as pulmonary edema, symptomatic sustained arrhythmia requiring specific therapy, stroke, cardiac arrest, or maternal death. Secondary outcomes were other cardiac, neonatal, and obstetric events.
RESULTS: Arrhythmias were the most common cause of referral to our dedicated cardio-obstetric clinic. A total of 92 patients were included, mean age 27±6 years; 8.7% had previous structural heart disease, and cardiology consultation was delayed in 79.4%. The most common arrhythmias were premature ventricular contractions (33%) and paroxysmal reentrant supraventricular tachycardias (15%); 11 patients (12%) had cardiac implantable electronic devices. Cardiac events occurred in 18.4% of patients, obstetric events occurred in 6.5%, and one caesarean was indicated in the context of symptomatic severe mitral stenosis. Adverse neonatal outcomes were observed in 24.3% of newborns.
CONCLUSIONS: Arrhythmias were the most common cause of referral to a dedicated cardio-obstetric clinic; most had a benign course. Adverse maternal cardiovascular outcomes were significant and there was a high rate of obstetric and neonatal adverse events, underlining the importance of multidisciplinary care.
方法:2016年至2019年进行了哥伦比亚妊娠和心血管疾病登记处的前瞻性队列研究。包括所有患有快速性心律失常或缓慢性心律失常的患者,以及分娩后至少六个月的随访。主要结局是心脏事件的复合定义为肺水肿,有症状的持续性心律失常需要特异性治疗,中风,心脏骤停,或产妇死亡。次要结果是其他心脏,新生儿,和产科事件。
结果:心律失常是转诊到我们专门的心血管产科诊所的最常见原因。共纳入92例患者,平均年龄27±6岁;8.7%以前有结构性心脏病,79.4%的患者延迟了心脏病学会诊.最常见的心律失常是室性早搏(33%)和阵发性折返性室上性心动过速(15%);11例患者(12%)具有心脏可植入电子设备。18.4%的患者发生心脏事件,产科事件发生在6.5%,在有症状的重度二尖瓣狭窄的情况下,需要进行一次剖腹产。在24.3%的新生儿中观察到不良的新生儿结局。
结论:心律失常是转诊到专门的心血管产科诊所的最常见原因;大多数是良性病程。不良孕产妇心血管结局显著,产科和新生儿不良事件发生率高,强调多学科护理的重要性。