title: Safety and efficacy of implantable cardioverter-defibrillator during pregnancy and after delivery.
abstract: BACKGROUND
  There are few studies of pregnancy and delivery in patients with an implantable cardioverter-defibrillator (ICD). The purpose of this study was to investigate maternal and fetal outcome in these patients.
  
  
  RESULTS
  Six pregnant women with an ICD were retrospectively reviewed. All women underwent implantation of an ICD before pregnancy and delivered at the National Cerebral and Cardiovascular Center. The mean age at pregnancy and the mean follow-up period after ICD implantation were 28±3 years old and 5±3 years, respectively. There was no device-related complication during pregnancy. In 4 women, the number of tachyarrhythmias such as non-sustained ventricular tachycardia increased after the end of the second trimester of pregnancy and anti-arrhythmic medications were gradually increased. No patient received discharges or shocks from the ICD during pregnancy, however, and only one required anti-tachycardia pacing at 27 weeks' gestation. Mean gestational age at delivery was 37±2 weeks and all deliveries were by cesarean section, including 5 as emergency deliveries due to a fetal indication. After delivery, 2 mothers had reduced cardiac function and 1 received an ICD shock for the first time.
  
  
  CONCLUSIONS
  Pregnancy did not increase the risk of an ICD-related complication under appropriate management. Additional caution might be required in the postpartum period as well as during pregnancy and labor.
authors.affiliation: Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan. gomiyoshi0327@yahoo.co.jp
authors.forename: Takekazu
authors.initials: T
authors.lastname: Miyoshi
authors.forename: Chizuko A
authors.initials: CA
authors.lastname: Kamiya
authors.forename: Shinji
authors.initials: S
authors.lastname: Katsuragi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Ueda
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Chinami
authors.initials: C
authors.lastname: Horiuchi
authors.forename: Kaoru
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Reiko
authors.initials: R
authors.lastname: Neki
authors.forename: Jun
authors.initials: J
authors.lastname: Yoshimatsu
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ikeda
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamada
authors.forename: Hideo
authors.initials: H
authors.lastname: Okamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Noda
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D002585:Cesarean Section; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation*; D004630:Emergencies; D005260:Female; D005865:Gestational Age; D006801:Humans; D050498:Live Birth; D049590:Postpartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents