One ominous case of focal atrial tachycardia in pregnancy, two victims and a successful outcome: a case report
Abstract Background Pregnancy is associated with both new-onset and exacerbation of pre-existing arrhythmias, particularly supraventricular tachycardia, with increased maternal and fetal risks and with added concerns on the safety of the available drug therapy and catheter ablation techniques. These...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | International Journal of Arrhythmia |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42444-022-00079-7 |
| _version_ | 1811315559149600768 |
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| author | João Grade Santos Alexandra Briosa Daniel Sebaiti Sofia Almeida Rita Miranda Luís Brandão Hélder Pereira |
| author_facet | João Grade Santos Alexandra Briosa Daniel Sebaiti Sofia Almeida Rita Miranda Luís Brandão Hélder Pereira |
| author_sort | João Grade Santos |
| collection | DOAJ |
| description | Abstract Background Pregnancy is associated with both new-onset and exacerbation of pre-existing arrhythmias, particularly supraventricular tachycardia, with increased maternal and fetal risks and with added concerns on the safety of the available drug therapy and catheter ablation techniques. These are often withheld, with worse outcomes, and lead to challenging decisions in the approach to pregnant women with refractory supraventricular arrhythmias. Case presentation We present a case of a 28-year-old 37-weeks pregnant woman with symptomatic, almost incessant, atrial tachycardia causing tachycardia-induced cardiomyopathy, refractory to medical therapy, that evolved in acute cardiac failure and needed emergency cesarian delivery. The patient was afterward submitted to catheter ablation therapy, with an electrical isolation of the ectopic foci on the lower left pulmonary vein with radiofrequency and total suppression of the arrhythmia. The patient and infant were discharged clinically well and during follow-up the patient was asymptomatic, without recurrence of tachycardia and with complete recovery of left ventricle function. Conclusions This case highlights the challenges in the treatment of this special population with a stepwise medical approach that proved ineffective and clinical deterioration requiring termination of pregnancy and catheter ablation in the postpartum period, with a successful maternal and fetal outcome. |
| first_indexed | 2024-04-13T11:33:31Z |
| format | Article |
| id | doaj.art-e676f3a238d84db89494e60f85f4cb90 |
| institution | Directory Open Access Journal |
| issn | 2466-1171 |
| language | English |
| last_indexed | 2024-04-13T11:33:31Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Arrhythmia |
| spelling | doaj.art-e676f3a238d84db89494e60f85f4cb902022-12-22T02:48:31ZengBMCInternational Journal of Arrhythmia2466-11712022-12-012311510.1186/s42444-022-00079-7One ominous case of focal atrial tachycardia in pregnancy, two victims and a successful outcome: a case reportJoão Grade Santos0Alexandra Briosa1Daniel Sebaiti2Sofia Almeida3Rita Miranda4Luís Brandão5Hélder Pereira6Cardiology Department, Hospital Garcia de OrtaCardiology Department, Hospital Garcia de OrtaCardiology Department, Hospital Garcia de OrtaCardiology Department, Hospital Garcia de OrtaCardiology Department, Hospital Garcia de OrtaCardiology Department, Hospital Garcia de OrtaCardiology Department, Hospital Garcia de OrtaAbstract Background Pregnancy is associated with both new-onset and exacerbation of pre-existing arrhythmias, particularly supraventricular tachycardia, with increased maternal and fetal risks and with added concerns on the safety of the available drug therapy and catheter ablation techniques. These are often withheld, with worse outcomes, and lead to challenging decisions in the approach to pregnant women with refractory supraventricular arrhythmias. Case presentation We present a case of a 28-year-old 37-weeks pregnant woman with symptomatic, almost incessant, atrial tachycardia causing tachycardia-induced cardiomyopathy, refractory to medical therapy, that evolved in acute cardiac failure and needed emergency cesarian delivery. The patient was afterward submitted to catheter ablation therapy, with an electrical isolation of the ectopic foci on the lower left pulmonary vein with radiofrequency and total suppression of the arrhythmia. The patient and infant were discharged clinically well and during follow-up the patient was asymptomatic, without recurrence of tachycardia and with complete recovery of left ventricle function. Conclusions This case highlights the challenges in the treatment of this special population with a stepwise medical approach that proved ineffective and clinical deterioration requiring termination of pregnancy and catheter ablation in the postpartum period, with a successful maternal and fetal outcome.https://doi.org/10.1186/s42444-022-00079-7Case reportFocal atrial tachycardiaTachycardia-induced cardiomyopathyArrhythmias in pregnancyCatheter ablation therapy |
| spellingShingle | João Grade Santos Alexandra Briosa Daniel Sebaiti Sofia Almeida Rita Miranda Luís Brandão Hélder Pereira One ominous case of focal atrial tachycardia in pregnancy, two victims and a successful outcome: a case report International Journal of Arrhythmia Case report Focal atrial tachycardia Tachycardia-induced cardiomyopathy Arrhythmias in pregnancy Catheter ablation therapy |
| title | One ominous case of focal atrial tachycardia in pregnancy, two victims and a successful outcome: a case report |
| title_full | One ominous case of focal atrial tachycardia in pregnancy, two victims and a successful outcome: a case report |
| title_fullStr | One ominous case of focal atrial tachycardia in pregnancy, two victims and a successful outcome: a case report |
| title_full_unstemmed | One ominous case of focal atrial tachycardia in pregnancy, two victims and a successful outcome: a case report |
| title_short | One ominous case of focal atrial tachycardia in pregnancy, two victims and a successful outcome: a case report |
| title_sort | one ominous case of focal atrial tachycardia in pregnancy two victims and a successful outcome a case report |
| topic | Case report Focal atrial tachycardia Tachycardia-induced cardiomyopathy Arrhythmias in pregnancy Catheter ablation therapy |
| url | https://doi.org/10.1186/s42444-022-00079-7 |
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