Abstract 18751: The Diverse Management and Prognosis of Supraventricular Tachycardia in Pregnant Women: Poor Prognosis for Pregnant Outcome in Patient With Non-psvt Pattern
Introduction: Supraventricular tachycardia (SVT) can be seen de novo or exacerbated by pregnancy, and can pose risks for both mother and fetus. But, the diverse management and fate of SVT in pregnant women were not well known.
Hypothesis: We hypothesized that pregnant women with non-PSVT had poor pregnant outcomes.
Methods: In 68 consecutive pregnant women with SVT, enrolled between January 2005 and April 2016. (mean age of 32±4 years), characteristics and pregnant outcomes were investigated during follow up period (median 272 days, 28-303 days). The primary endpoint was pregnant outcome as adverse pregnant events, which were composite of abortion, pre-term labor, late-term labor, fetal deformity at birth, and abnormal fetal birth weight (<10 or >90 percentile of birth weight).
Results: PSVT was the most frequent SVT (n=23, 33.8%) in this study. Non-PSVT were consisted of atrial tachycardia (n=12, 17.6%), atrial flutter (n=5, 7.4%), atrial fibrillation (n=12, 17.6%), and pre-excitation (n=16, 23.5%). SVT was first documented in 38 (56%) patients, and preexisting SVT was aggravated in 8 (12%) patients. While 18 out of 45 patients (40%) with non-PSVT had adverse pregnant events, patients with PSVT had 2 events (p = 0.07). No abortion events were occurred in patients with PSVT, compared with those with non-PSVT (p = 0.013). The Kaplan-Meier curve showed that patients with non-PSVT were associated with higher adverse pregnant events rather than those with PSVT (Log Rank, p = 0.008). Multivariate Cox regression analysis revealed that patients with non-PSVT underwent an independent poor prognosis for pregnant outcomes (HR 4.918, 95% CI 1.059-22.846, p = 0.042) when controlled for age, BMI, hemoglobin, and history of heart failure.
Conclusions: Pregnant women with non-PSVT are associated with independent poor pregnant outcomes, compared with those with PSVT. Therefore, pregnant women with non-PSVT should be meticulously managed and treated before pregnancy if possible.
Author Disclosures: J. Park: None. T. Kim: None. J. Uhm: None. H. Pak: None. M. Lee: None. B. Joung: None.
- © 2016 by American Heart Association, Inc.