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Pregnancies, ventricular arrhythmias, and substrate progression in women with arrhythmogenic right ventricular cardiomyopathy in the Nordic ARVC Registry

Platonov, Pyotr G. LU ; Castrini, Anna I. ; Svensson, Anneli ; Christiansen, Morten K. ; Gilljam, Thomas ; Bundgaard, Henning ; Madsen, Trine ; Heliö, Tiina ; Christensen, Alex H. and Åström, Meriam Aneq , et al. (2020) In Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 22(12). p.1873-1879
Abstract

AIMS: Women with arrhythmogenic right ventricular cardiomyopathy (ARVC) are at relatively lower risk of ventricular arrhythmias (VAs) than men, but the physical burden associated with pregnancy on VA risk remains insufficiently studied. We aimed to assess the risk of VA in relation to pregnancies in women with ARVC. METHODS AND RESULTS: We included 199 females with definite ARVC (n = 121) and mutation-positive family members without ascertained ARVC diagnosis (n = 78), of whom 120 had at least one childbirth. Ventricular arrhythmia-free survival after the latest childbirth was compared between women with one (n = 20), two (n = 67), and three or more (n = 37) childbirths. Cumulative probability of VA for each pregnancy (n = 261) was... (More)

AIMS: Women with arrhythmogenic right ventricular cardiomyopathy (ARVC) are at relatively lower risk of ventricular arrhythmias (VAs) than men, but the physical burden associated with pregnancy on VA risk remains insufficiently studied. We aimed to assess the risk of VA in relation to pregnancies in women with ARVC. METHODS AND RESULTS: We included 199 females with definite ARVC (n = 121) and mutation-positive family members without ascertained ARVC diagnosis (n = 78), of whom 120 had at least one childbirth. Ventricular arrhythmia-free survival after the latest childbirth was compared between women with one (n = 20), two (n = 67), and three or more (n = 37) childbirths. Cumulative probability of VA for each pregnancy (n = 261) was assessed from conception through 2 years after childbirth and compared between those pregnancies that occurred before (n = 191) or after (n = 19) ARVC diagnosis and in mutation-positive family members (n = 51). The nulliparous women had lower median age at ARVC diagnosis (38 vs. 42 years, P < 0.001) and first VA (22 vs. 41 years, P < 0.001). Ventricular arrhythmia-free survival after the latest childbirth was not related to the number of pregnancies. No pregnancy-related VA was reported among the family members. Women who gave birth after ARVC diagnosis had elevated risk of VA postpartum (hazard ratio 13.74, 95% confidence interval 2.9-63, P = 0.001), though only two events occurred during pregnancies. CONCLUSION: In women with ARVC, pregnancy was uneventful for the overwhelming majority and the number of prior completed pregnancies was not associated with VA risk. Pregnancy-related VA was primarily related to the phenotypical severity rather than pregnancy itself.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Arrhythmogenic right ventricular cardiomyopathy, Pregnancy, Risk stratification
in
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
volume
22
issue
12
pages
7 pages
publisher
Oxford University Press
external identifiers
  • scopus:85099073415
  • pmid:32681178
ISSN
1532-2092
DOI
10.1093/europace/euaa136
language
English
LU publication?
yes
id
07c7d409-4f99-49f6-91cd-cbda0d05233d
date added to LUP
2021-01-21 13:12:11
date last changed
2024-05-02 02:06:39
@article{07c7d409-4f99-49f6-91cd-cbda0d05233d,
  abstract     = {{<p>AIMS: Women with arrhythmogenic right ventricular cardiomyopathy (ARVC) are at relatively lower risk of ventricular arrhythmias (VAs) than men, but the physical burden associated with pregnancy on VA risk remains insufficiently studied. We aimed to assess the risk of VA in relation to pregnancies in women with ARVC. METHODS AND RESULTS: We included 199 females with definite ARVC (n = 121) and mutation-positive family members without ascertained ARVC diagnosis (n = 78), of whom 120 had at least one childbirth. Ventricular arrhythmia-free survival after the latest childbirth was compared between women with one (n = 20), two (n = 67), and three or more (n = 37) childbirths. Cumulative probability of VA for each pregnancy (n = 261) was assessed from conception through 2 years after childbirth and compared between those pregnancies that occurred before (n = 191) or after (n = 19) ARVC diagnosis and in mutation-positive family members (n = 51). The nulliparous women had lower median age at ARVC diagnosis (38 vs. 42 years, P &lt; 0.001) and first VA (22 vs. 41 years, P &lt; 0.001). Ventricular arrhythmia-free survival after the latest childbirth was not related to the number of pregnancies. No pregnancy-related VA was reported among the family members. Women who gave birth after ARVC diagnosis had elevated risk of VA postpartum (hazard ratio 13.74, 95% confidence interval 2.9-63, P = 0.001), though only two events occurred during pregnancies. CONCLUSION: In women with ARVC, pregnancy was uneventful for the overwhelming majority and the number of prior completed pregnancies was not associated with VA risk. Pregnancy-related VA was primarily related to the phenotypical severity rather than pregnancy itself.</p>}},
  author       = {{Platonov, Pyotr G. and Castrini, Anna I. and Svensson, Anneli and Christiansen, Morten K. and Gilljam, Thomas and Bundgaard, Henning and Madsen, Trine and Heliö, Tiina and Christensen, Alex H. and Åström, Meriam Aneq and Carlson, Jonas and Edvardsen, Thor and Jensen, Henrik K. and Haugaa, Kristina H. and Svendsen, Jesper H.}},
  issn         = {{1532-2092}},
  keywords     = {{Arrhythmogenic right ventricular cardiomyopathy; Pregnancy; Risk stratification}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{1873--1879}},
  publisher    = {{Oxford University Press}},
  series       = {{Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology}},
  title        = {{Pregnancies, ventricular arrhythmias, and substrate progression in women with arrhythmogenic right ventricular cardiomyopathy in the Nordic ARVC Registry}},
  url          = {{http://dx.doi.org/10.1093/europace/euaa136}},
  doi          = {{10.1093/europace/euaa136}},
  volume       = {{22}},
  year         = {{2020}},
}