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Direct current cardioversion in pregnancy: a multicentre study.

Matthew Cauldwell1, Dawn Adamson2, Kaliash Bhatia3

  • 1Department of Obstetrics, Maternal Medicine Service, St George's Hospital, Blackshaw Road, London, UK.

BJOG : an International Journal of Obstetrics and Gynaecology
|April 11, 2023
PubMed
Summary
This summary is machine-generated.

Direct current cardioversion (DCCV) in pregnancy is a rare but necessary procedure. This study found no maternal deaths in 27 cases, with all 29 pregnancies resulting in live births, emphasizing its safety when indicated.

Keywords:
arrhythmiaatrial fibrillationatrial fluttercardioversionheart diseasematernalmorbiditytachycardia

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Area of Science:

  • Cardiology
  • Maternal-Fetal Medicine
  • Obstetrics

Background:

  • Direct current cardioversion (DCCV) during pregnancy is infrequently documented.
  • Concerns exist regarding withheld DCCV in pregnant patients, potentially leading to adverse maternal outcomes.

Purpose of the Study:

  • To evaluate maternal and fetal outcomes following direct current cardioversion (DCCV) in pregnant women.
  • To assess the safety and efficacy of DCCV in managing cardiac arrhythmias during gestation.

Main Methods:

  • Retrospective cohort study involving 27 pregnant women who underwent DCCV.
  • Data collected from 17 specialist maternity centres across the UK and Ireland.

Main Results:

  • No maternal deaths occurred among the 27 women undergoing 29 DCCVs.
  • All 29 pregnancies resulted in live births, with a median delivery gestation of 35 weeks.
  • Common arrhythmias included atrial fibrillation (44%) and atrial flutter (30%); fetal monitoring was inconsistently applied post-procedure.

Conclusions:

  • Direct current cardioversion (DCCV) in pregnancy is safe and effective when clinically indicated, with no reported maternal mortality in this cohort.
  • Post-DCCV, appropriate fetal monitoring based on gestational age is recommended.
  • Maternity units should establish multidisciplinary protocols to ensure pregnant women receive timely and equivalent care for cardiac conditions.