在怀孕期间心律失常症中死产和早产的风险
Yong Hao Yeo1, Boon Jian San2, Xuan Ci Mee3
1Department of Internal Medicine/Pediatrics, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA.
JACC. Clinical electrophysiology
|May 15, 2025
概括
怀孕妇女的心脏节律失常,虽然罕见,但正在增加. 心室心律不整 (VA) 显著增加死胎风险,而所有类型都会增加早产风险. 心脏转变/除没有显示增加风险.
科学领域:
- 心脏病学 心脏病学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 流行病学 流行病学
背景情况:
- 怀孕妇女心律不整的发病率不断上升,需要了解相关风险.
- 有限的国家数据存在于怀孕妇女与心律失常的死产和早产的风险.
研究的目的:
- 评估心脏节律失常症与孕妇死产和早产风险之间的关联.
- 为了比较有心律失常和没有心律失常的孕妇之间的结果.
主要方法:
- 利用全国再接收数据库 (2017-2020年) 对心脏节拍不良的孕妇 (心房动/动[AF],心室节律不良[VA],脑上心室节拍不良[SVT]).
- 员工倾向得分匹配和多变量分析,以评估动脉节律失常与死产和早产的关联.
- 通过ICD-10-CM代码识别的心律失常患者和对照组之间的结果进行了比较.
主要成果:
- 7,517,975名孕妇中,0.2%的孕妇患有心脏节拍不良,其中SVT是最常见的.
- 腹腔失常 (VA) 显著增加死胎几率 (aOR:3.83),而SVT和AF则没有.
- 所有动脉节律失常的亚型 (VA,AF,SVT) 都与早产的更高几率有显著的关联.
结论:
- 怀孕期间心脏节律失常的患病率很低,但正在增加,VA具有显著的死产风险.
- 所有研究的动脉节律障碍类型都与早产风险增加有关.
- 在这个人群中,心脏转换/除手术似乎没有增加死产或早产的风险.
相关概念视频
01:28Mechanism of Cardiac Arrhythmias
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Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
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01:28Disturbances in Heart Rhythm
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Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
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01:16ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
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Arrhythmias are disturbances in the heart's rhythm that lead to abnormal heartbeats. These irregularities can originate from different parts of the heart and are classified based on their origin and nature.
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Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...
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01:07Teratogenicity
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01:14Decreased pulse rate
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Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
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01:24Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
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Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
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