Abstract：
OBJECTIVE: Cardiovascular disease is a common cause of morbidity and mortality in pregnant women. Arrhythmias are common complications during pregnancy; however, the data are limited. Our goal was to characterize the epidemiology, clinical presentation, and impact of cardiac arrhythmias on maternal-fetal outcomes.
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.
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.
摘要：
目的：心血管疾病是孕妇发病和死亡的常见原因。心律失常是怀孕期间常见的并发症;然而，数据有限。我们的目标是描述流行病学特征，临床表现,以及心律失常对母胎结局的影响。
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。
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。
