title: Ventricular tachyarrhythmia during pregnancy in women with heart disease: Data from the ROPAC, a registry from the European Society of Cardiology.
abstract: OBJECTIVE
  To describe the incidence, onset, predictors and outcome of ventricular tachyarrhythmia (VTA) in pregnant women with heart disease.
  
  
  BACKGROUND
  VTA during pregnancy will cause maternal morbidity and even mortality and will have impact on fetal outcome. Insufficient data exist on the incidence and outcome of VTA in pregnancy.
  
  
  RESULTS
  From January 2007 up to October 2013, 99 hospitals in 39 countries enrolled 2966 pregnancies in women with structural heart disease. Forty-two women (1.4%) developed clinically relevant VTA during pregnancy, which occurred mainly in the third trimester (48%). NYHA class >1 before pregnancy was an independent predictor for VTA. Heart failure during pregnancy was more common in women with VTA than in women without VTA (24% vs. 12%, p=0.03) and maternal mortality was respectively 2.4% and 0.3% (p=0.15). More women with VTA delivered by Cesarean section than women without VTA (68% vs. 47%, p=0.01). Neonatal death, preterm birth (<37weeks), low birthweight (<2500g) and Apgar score <7 occurred more often in women with VTA (4.8% vs. 0.3%, p=0.01; 36% vs. 16%, p=0.001; 33% vs. 15%, p=0.001 and 25% vs. 7.3%, p=0.001, respectively).
  
  
  CONCLUSIONS
  VTA occurred in 1.4% of pregnant women with cardiovascular disease, mainly in the third trimester, and was associated with heart failure during pregnancy. NYHA class before pregnancy was predictive. VTA during pregnancy had clear impact on fetal outcome.
authors.affiliation: Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Ebru
authors.initials: E
authors.lastname: Ertekin
authors.affiliation: Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Iris M
authors.initials: IM
authors.lastname: van Hagen
authors.affiliation: Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Amar M
authors.initials: AM
authors.lastname: Salam
authors.affiliation: Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Titia P E
authors.initials: TP
authors.lastname: Ruys
authors.affiliation: Imperial College School of Medicine, Chelsea and Westminster Hospital, London, United Kingdom.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Johnson
authors.affiliation: Hospital Na Homolce & Pediatric Heart Center University Hospital Motol, Prague, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Popelova
authors.affiliation: Royal Brisbane & Women's Hospital, Herston, Australia.
authors.forename: William A
authors.initials: WA
authors.lastname: Parsonage
authors.affiliation: Cairo University, Cairo, Egypt.
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Ashour
authors.affiliation: Hillel Yaffe Medical Center, Hadera, Israel.
authors.forename: Avraham
authors.initials: A
authors.lastname: Shotan
authors.affiliation: Adult Congenital Heart Disease Unit, La Paz University Hospital, Madrid, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Oliver
authors.affiliation: Adolescent and Adult Congenital Heart Program, Cincinnati Children's Hospital, Cincinnati,United States.
authors.forename: Gruschen R
authors.initials: GR
authors.lastname: Veldtman
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
authors.forename: Roger
authors.initials: R
authors.lastname: Hall
authors.affiliation: Erasmus University Medical Center, Rotterdam, The Netherlands; Fellow of the European Society of Cardiology, Sophia Antipolis Cedex, France. Electronic address: j.roos@erasmusmc.nl.
authors.forename: Jolien W
authors.initials: JW
authors.lastname: Roos-Hesselink
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007391:International Cooperation; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000401:mortality; D011256:Pregnancy Outcome / Q000453:epidemiology; D011263:Pregnancy Trimester, Third; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology; D012042:Registries / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology / Q000401:mortality
keywords: Cardiovascular disease; Fetal outcome; Maternal outcome; Pregnancy; Ventricular tachyarrhythmia