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Emergency therapy of maternal and fetal arrhythmias during pregnancy.
MedLine Citation:
PMID:  20606792     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Atrial premature beats are frequently diagnosed during pregnancy (PR); supraventricular tachycardia (SVT) (atrial tachycardia, AV-nodal reentrant tachycardia, circus movement tachycardia) is less frequently diagnosed. For acute therapy, electrical cardioversion with 50-100 J is indicated in all unstable patients (pts). In stable SVT, the initial therapy includes vagal maneuvers to terminate tachycardias. For short-term management, when vagal maneuvers fail, intravenous adenosine is the first choice drug and may safely terminate the arrhythmia. Ventricular premature beats are also frequently present during PR and benign in most of the pts; however, malignant ventricular tachyarrhythmias (sustained ventricular tachycardia [VT], ventricular flutter [VFlut] or ventricular fibrillation [VF]) may occur. Electrical cardioversion is necessary in all pts who are in hemodynamically unstable situation with life-threatening ventricular tachyarrhythmias. In hemodynamically stable pts, initial therapy with ajmaline, procainamide or lidocaine is indicated. In pts with syncopal VT, VF, VFlut or aborted sudden death, an implantable cardioverter-defibrillator is indicated. In pts with symptomatic bradycardia, a pacemaker can be implanted using echocardiography at any stage of PR. The treatment of the pregnant patient with cardiac arrhythmias requires important modifications of the standard practice of arrhythmia management. The goal of therapy is to protect the patient and fetus through delivery, after which chronic or definitive therapy can be administered.
Authors:
Hans-Joachim Trappe
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of emergencies, trauma, and shock     Volume:  3     ISSN:  0974-519X     ISO Abbreviation:  J Emerg Trauma Shock     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-07-07     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101493921     Medline TA:  J Emerg Trauma Shock     Country:  India    
Other Details:
Languages:  eng     Pagination:  153-9     Citation Subset:  -    
Affiliation:
Department of Cardiology and Angiology, University of Bochum, Germany.
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