Abstract
We report two cases undergoing electrophysiological studies for ventricular arrhythmias (VAs) associated with peripartum cardiomyopathy. Those two cases demonstrated that subsequent pregnancies might result in deterioration of VAs even though they exhibit no symptoms of heart failure. Those findings may clinically impact the decision making when women with a history of peripartum cardiomyopathy desire to become pregnant again. The VA foci in both cases were determined or suggested to be in the epicardium of the ventricular outflow tract from the results of the catheter ablation and electrophysiological study. Therefore, catheter ablation of those VAs may be feasible but challenging.
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References
Homans, D. C. (1985). Peripartum cardiomyopathy. The New England Journal of Medicine, 312, 1432–1437.
Demakis, J. G., Rahimtoola, S. H., Sutton, G. C., Meadows, W. R., Szanto, P. B., Tobin, J. R., et al. (1971). Natural course of peripartum cardiomyopathy. Circulation, 44, 1053–1061.
Palma, E. C., Saxenberg, V., Vijayaraman, P., Ferrick, K. J., Gross, J. N., Kim, S. G., et al. (2001). Histopathological correlation of ablation lesions guided by noncontact mapping in a patient with peripartum cardiomyopathy and ventricular tachycardia. Pacing and Clinical Electrophysiology, 24, 1812–1815.
Gemici, G., Tezcan, H., Fak, A. S., & Oktay, A. (2004). Peripartum cardiomyopathy presenting with repetitive monomorphic ventricular tachycardia. Pacing and Clinical Electrophysiology, 27, 557–558.
Berruezo, A., Mont, L., Nava, S., Chueca, E., Bartholomay, E., & Brugada, J. (2004). Electrocardiographic recognition of the epicardial origin of ventricular tachycardias. Circulation, 109, 1842–1847.
Daniels, D. V., Lu, Y. Y., Morton, J. B., Santucci, P. A., Akar, J. G., Green, A., et al. (2006). Idiopathic epicardial left ventricular tachycardia originating remote from the sinus of Valsalva: electrophysiological characteristics, catheter ablation, and identification from the 12-lead electrocardiogram. Circulation, 113, 1659–1666.
Yamada, T., Murakami, Y., Yoshida, N., Okada, T., Toyama, J., Yoshida, Y., et al. (2007). Efficacy of electroanatomic mapping in the catheter ablation of premature ventricular contractions originating from the right ventricular outflow tract. Journal of Interventional Cardiac Electrophysiology, 19, 187–194.
Elkayam, U., Tummala, P. P., Rao, K., Akhter, M. W., Karaalp, I. S., Wani, O. R., et al. (2001). Maternal and fetal outcomes of subsequent pregnancies in women with peripartum cardiomyopathy. The New England Journal of Medicine, 344, 1567–1571.
Soejima, K., Stevenson, W. G., Sapp, J. L., Selwyn, A. P., Couper, G., & Epstein, L. M. (2004). Endocardial and epicardial radiofrequency ablation of ventricular tachycardia associated with dilated cardiomyopathy: the importance of low-voltage scars. Journal of the American College of Cardiology, 43, 1834–1842.
Dalal, D., Jain, R., Tandri, H., Dong, J., Eid, S. M., Prakasa, K., et al. (2007). Long-term efficacy of catheter ablation of ventricular tachycardia in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy. Journal of the American College of Cardiology, 50, 432–440.
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Yamada, T., McElderry, H.T., Muto, M. et al. Ventricular arrhythmias originating from the epicardial ventricular outflow tract complicated with peripartum cardiomyopathy. J Interv Card Electrophysiol 25, 53–57 (2009). https://doi.org/10.1007/s10840-008-9325-z
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DOI: https://doi.org/10.1007/s10840-008-9325-z