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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2019, Number 05

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Ginecol Obstet Mex 2019; 87 (05)

Electrical cardioversion of ventricular tachycardia in pregnancy: case report

Añas-Méndez ML, Aquino-Bruno H, Enriquez-Silverio A, de la Fuente-Macip C, Rojel-Martínez U
Full text How to cite this article

Language: Spanish
References: 9
Page: 319-323
PDF size: 1320.32 Kb.


Key words:

Ventricular tachycardia, Electrical cardioversion, Pregnancy.

ABSTRACT

Background: Cardiac arrhythmias are frequent complications in pregnancy, the most of them are benign and don’t need specific treatment. Idiopathic ventricular tachycardia usually is hemodynamically stable and associate with a good prognosis.
Clinic case: A 22-year-old woman with a current pregnancy of 23.4 weeks of gestation that began with dizziness and palpitations, she went to the emergency department, a 12-lead electrocardiogram showed a wide QRS tachycardia with fusion beats and atrioventricular dissociation, the echocardiogram was reported normal. Posterior fascicular ventricular idiopathic tachycardia was concluded. Initially, Verapamil and Amiodarone were administered for 48 hours, with tachycardia persisting, so it was decided to perform electrical cardioversion with 200 Joules that was effective. She remained asymptomatic until the 31st week of gestation where she started again with palpitations, the same tachycardia was documented and it was decided to perform again electrical cardioversion with 200 joules, being effective and without complications.
Conclusions: Idiopathic ventricular tachycardia occurs with low frequency in pregnancy. When pharmacological therapy is not effective or there is hemodynamic instability, electrical cardioversion is a viable option in the pregnant patient.


REFERENCES

  1. Singh V, et al. Cardioversion in late pregnancy: a case report. Acta Anaesth. Belg 2014;65(3):105-107. https:// pdfs.semanticscholar.org/cee0/caf06c8491d4c60a31f1f- 7d96e137d07f7b7.pdf

  2. Enriquez AD, et al. Contemporary management of arrhythmias during pregnancy. Circ Arrhythm Electrophysiol 2014;7:961-967. https://doi.org/10.1161/CIRCEP.114.001517

  3. Tromp CHN, et al. Electrical cardioversion during pregnancy: safe or not? Neth Heart J 2011;19(3):134. https://doi. org/10.1007/s12471-011-0077-5

  4. Ortiz-Muñoz E, et al. Arritmias en la paciente embarazada. Rev Colomb Cardiol 2017;24(4):388-393. https://dx.doi. org/10.1016/j.rccar.2016.11.008

  5. Enderlin EA, et al. Management of tachyarrhythmia during pregnancy. Turk Kardiyol Dern Ars 2017;45(2):189-196. https://doi.org/10.5543/tkda.2016.78606

  6. Joglar JA, et al. Management of arrhythmia syndromes during pregnancy. Curr Opin Cardiol 2014;29(1):36-44. https://doi.org/10.1097/HCO.0000000000000020

  7. Cleary-Goldman J, et al. Case report verapamil-sensitive idiopathic left ventricular tachycardia in pregnancy. J Matern Fetal Neonatal Med 2003;14(2):132-5. https://doi. org/10.1080/jmf.14.2.132.135

  8. Dieste-Pérez P, et al. Taquicardia supraventricular en gestante a término: a propósito de un caso. Ginecol Obstet Mex 2015;83(9):561-568. https://ginecologiayobstetricia. org.mx/secciones/casos-clinicos/ taquicardia-supraventricular-en-gestante-a-termino-aproposito- de-un-caso/

  9. Román-Rubio P, et al. Cardioversión eléctrica durante el embarazo. Rev Cub Med Int Emerg 2009;8(2). http://bvs. sld.cu/revistas/mie/vol8_2_09/mie09209.pdf




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Ginecol Obstet Mex. 2019;87