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Pregnancy and cesarean section in a patient with a rate-responsive pacemaker
C Andersen1, H Oxhøj, P Arnsbo
1Department of Clinical Physiology, Odense University Hospital, Denmark.
Pacing and Clinical Electrophysiology : PACE
|February 1, 1989
Summary
Rate-responsive pacemakers function adequately during pregnancy and cesarean delivery in women with complete atrioventricular block. Pacing rates remained stable, with adjustments noted during fetal movement and cesarean delivery.
Area of Science:
- Cardiology
- Obstetrics
- Biomedical Engineering
Background:
- Complete atrioventricular block necessitates pacemaker implantation for hemodynamic stability.
- Pregnancy and cesarean section present unique physiological challenges impacting cardiac function.
- Rate-responsive pacemakers aim to adapt cardiac output to metabolic demands.
Observation:
- A woman with complete atrioventricular block and a rate-responsive pacemaker was monitored throughout pregnancy and cesarean section.
- Comparative data were collected from a pregnant woman without cardiac conditions and 12 women undergoing elective cesarean section.
- Heart rate responses to physiological changes like fetal movement and surgical stress were recorded.
Findings:
- The pacemaker-dependent woman's pacing rate remained stable during pregnancy, unlike the physiological heart rate increase in the control subject.
- Fetal movement in late gestation triggered an increase in pacing rate, a response not observed in the control.
- During cesarean section, the pacemaker's pacing rate generally fell within the normal range (mean +/- 1 SD) observed in healthy women.
Implications:
- Rate-responsive pacemakers can effectively manage heart rate in pregnant women with complete atrioventricular block.
- Pacemaker function appears adaptable to the physiological stresses of pregnancy and cesarean delivery.
- Further research may optimize pacemaker settings for pregnant women with conduction abnormalities.