title: Pregnancy outcome and management of women with an implantable cardioverter defibrillator: a single centre experience.
abstract: OBJECTIVE
  With improved survival of patients with congenital and inherited heart disease, there is now a younger cohort of patients with an implantable cardioverter defibrillator (ICD) for the prevention and treatment of ventricular dysrrhythmias. Young women with such disorders often wish to embark on pregnancy, but pregnancy outcome data for this group is sparse. We therefore evaluated pregnancy outcome in patients with heart disease and an ICD in situ.
  
  
  RESULTS
  A retrospective analysis was performed on all women with an ICD in situ, who had pregnancy care provided by the specialist maternal cardiology service at University College London Hospitals. Data for 19 pregnancies in 14 women were collected. The underlying cardiac diagnoses were congenital heart disease (one), familial hypertrophic cardiomyopathy (eight), familial dilated cardiomyopathy (one), inherited long QT syndrome (one), and idiopathic cardiac arrest (one). Three women had moderate impairment of the left ventricular systolic function (ejection fraction <45%), in the remainder it was normal. Nine ICD implants were for primary prevention of sudden cardiac death (64%) and five for secondary prevention (36%). Of the 19 pregnancies, 18 continued beyond 24 weeks gestation with 18 live births. In eight pregnancies there were medical or device-related complications (42.9%) as follows: arrhythmias (four) (21.1%), heart failure (two) (9.1%), ICD shocks (one) (5.3%), atrial lead fracture (one) (5.3%), and lead-related thrombus (one) (5.3%). There were no inappropriate device shocks or therapies.
  
  
  CONCLUSIONS
  Women with heart disease and an ICD implant can have a good outcome during pregnancy but medical and device complications are not uncommon.
authors: The Grown Up Congenital Heart Disease Unit, The Heart Hospital, University College London Hospitals (UCLH) NHS Trust, London, UK. schulerp@gmx.de
authors: Pia K
authors: PK
authors: Schuler
authors: Anna
authors: A
authors: Herrey
authors: Angie
authors: A
authors: Wade
authors: Ruth
authors: R
authors: Brooks
authors: Donald
authors: D
authors: Peebles
authors: Pier
authors: P
authors: Lambiase
authors: Fiona
authors: F
authors: Walker
mesh_terms: D017147:Defibrillators, Implantable / Q000009:adverse effects*; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000517:prevention & control*; D011256:Pregnancy Outcome; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000150:complications* / Q000517:prevention & control*; D016387:Women's Health