Abstract
In part two of the Gender differences in cardiac electrophysiology and arrhythmia we are reviewing the incidence of polymorphic ventricular tachycardia, sudden cardiac death and rhythm disturbances during pregnancy. Polymorphic ventricular tachycardia and its specific form "Torsade de Polntes" Is seen in patients with congenital and drug induced long QT syndrome, and incomplete AV block. Regardless of it cause, polymorphic ventricular tachycardia is more common in women. On the other hand, the incidence of sudden cardiac death is higher in men than women due to higher frequency of ischemic heart disease men. In addition, sudden cardiac death is lower women regardless of age and traditional risk factors such as coronary artery disease, impaired left ventricular function and previous myocardial infarction. Left ventricular hypertrophy is an important risk factor for sudden cardiac death in women. There is no difference in the efficacy of antiarrhythmic therapy and ICDs for sudden cardiac death in men women. Atrial and ventricular premature beats are not infrequent during pregnancy while supraventricular and ventricular tachyardias are less frequent. In some patients with history of supraventricular tachyardias or Wolff-Parkinson-White syndrome pregnancy might exacerbate these rhythm disturbances. There is also some suggestion of increased risk of cardiac events in the postpartum period in patients with congenital long QT syndrome. An important management question is antiarrhythmic therapy during pregnancy because there are no entirely save antiarrhythmic drugs particularly during the first 3 months. Selective beta 1 blocking agents should be considered as the initial treatment for symptomatic arrhythmias. In hemodynamically unstable tachyarrhythmias cardioversion is save and indicated.
Original language | English |
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Pages (from-to) | 22-28 |
Number of pages | 7 |
Journal | Kardiologia |
Volume | 16 |
Issue number | 1 |
State | Published - Jan 2007 |
Externally published | Yes |
Keywords
- Arrythmias
- Arrythmias in pregnancy
- Gender differences
- QT interval
- Sudden cardiac death