Cardiac implantable electronic devices in pregnancy: A position statement.

Area of Science:

• Cardiology
• Obstetrics
• Medical Device Management

Background:

• Cardiac implantable electronic devices (CIEDs) like permanent pacemakers (PPM) and implantable cardioverter defibrillators (ICD) are increasingly prevalent in women of childbearing age.
• Pregnancy presents unique physiological challenges that can affect CIED function and patient management.
• A need exists for updated, evidence-based guidelines for managing CIEDs during pregnancy, childbirth, and the postpartum period.

Purpose of the Study:

• To provide comprehensive guidance for the obstetric management of women and birthing people with PPM or ICD.
• To establish contemporary, evidence-based recommendations for safe and effective care.
• To reduce the risk of adverse events related to CIEDs throughout the pregnancy continuum.

Main Methods:

• Systematic review of existing literature on CIEDs in pregnancy.
• Expert consensus development for areas with limited evidence.
• Formulation of clinical recommendations based on synthesized data.

Main Results:

• The document outlines management strategies for various stages, including preconception, pregnancy, labor, and postpartum.
• Recommendations address device interrogation, programming adjustments, and potential complications.
• Expert consensus provides guidance where robust clinical trial data is scarce.

Conclusions:

• Implementing standardized management protocols for CIEDs in pregnancy is crucial.
• Adherence to these guidelines can improve maternal and fetal outcomes.
• This document serves as a vital resource for healthcare providers managing this growing patient population.