Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Arrhythmania/Electrophysiology
Safety and Efficacy of Implantable CardioverterDefibrillator During Pregnancy and After Delivery
Takekazu MiyoshiChizuko A. KamiyaShinji KatsuragiHiroto UedaYoshinari KobayashiChinami HoriuchiKaoru YamanakaReiko NekiJun YoshimatsuTomoaki IkedaYuko YamadaHideo OkamuraTakashi NodaWataru Shimizu
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JOURNAL FREE ACCESS

2013 Volume 77 Issue 5 Pages 1166-1170

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Abstract

Background: There are few studies of pregnancy and delivery in patients with an implantable cardioverter-defibrillator (ICD). The purpose of this study was to investigate maternal and fetal outcome in these patients. Methods and Results: Six pregnant women with an ICD were retrospectively reviewed. All women underwent implantation of an ICD before pregnancy and delivered at the National Cerebral and Cardiovascular Center. The mean age at pregnancy and the mean follow-up period after ICD implantation were 28±3 years old and 5±3 years, respectively. There was no device-related complication during pregnancy. In 4 women, the number of tachyarrhythmias such as non-sustained ventricular tachycardia increased after the end of the second trimester of pregnancy and anti-arrhythmic medications were gradually increased. No patient received discharges or shocks from the ICD during pregnancy, however, and only one required anti-tachycardia pacing at 27 weeks’ gestation. Mean gestational age at delivery was 37±2 weeks and all deliveries were by cesarean section, including 5 as emergency deliveries due to a fetal indication. After delivery, 2 mothers had reduced cardiac function and 1 received an ICD shock for the first time. Conclusions: Pregnancy did not increase the risk of an ICD-related complication under appropriate management. Additional caution might be required in the postpartum period as well as during pregnancy and labor.  (Circ J 2013; 77: 1166–1170)

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© 2013 THE JAPANESE CIRCULATION SOCIETY
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