ECG and arrhythmias in peripartum cardiomyopathy

EKG und Arrhythmien bei Peripartumkardiomyopathie

Abstract

Peripartum cardiomyopathy (PPCM) is a rare but life-threatening heart disease, with onset in the last month of pregnancy or in the first months after delivery. Extensive studies on the burden of supraventricular and ventricular arrhythmias are lacking. Patients with PPCM present with electrocardiographic findings typical in acute heart failure. Management of arrhythmias in PPCM depends on the severity and the onset (during pregnancy or after delivery). Studies on the use of the wearable cardioverter–defibrillator in patients with PPCM show a substantial burden of ventricular tachyarrhythmias and sudden death in patients with severely reduced left ventricular function. The aim of the present article is to summarize actual knowledge on electrocardiogram findings, arrhythmias, and sudden cardiac death in patients with PPCM.

Zusammenfassung

Die Peripartumkardiomyopathie (PPCM) ist eine seltene, aber lebensbedrohliche Herzerkrankung, die in den letzten Schwangerschaftsmonaten oder den ersten Monaten nach der Entbindung auftritt. Detaillierte Studien zur Arrhythmielast durch supraventrikuläre und ventrikuläre Arrhythmien bei PPCM liegen nicht vor. Patientinnen mit PPCM weisen die typischen EKG-Befunde einer akuten Herzinsuffizienz auf. Die Behandlung von Arrhythmien bei PPCM hängt von der Schwere und vom Zeitpunkt des Auftretens – während der Schwangerschaft oder nach der Entbindung – ab. Studien mit tragbaren Defibrillatoren bei Patientinnen mit PPCM konnten relevante ventrikuläre Tachyarrhythmien und plötzlichen Herztod bei Patientinnen mit schwer eingeschränkter linksventrikulärer Funktion nachweisen. Ziel der vorliegenden Übersichtsarbeit ist es, die aktuelle Datenlage zu EKG, Arrhythmien und plötzlichem Herztod bei Patientinnen mit PPCM zusammenzufassen.

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Correspondence to PD Dr. David Duncker.

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Conflict of interest

D. Duncker has received speaker honoraria and/or travel grants from Abbott, Astra Zeneca, Bayer, Biotronik, Boehringer Ingelheim, Boston Scientific, Medtronic, Pfizer, and Zoll. J. Bauersachs reports honoraria for lectures and/or consulting from Novartis, BMS, Pfizer, Vifor, Bayer, Servier, Daichii Sankyo, CVRx, MSD, Boehringer Ingelheim, Cardior, AstraZeneca, Abiomed, Abbott, and Medtronic, and research support from Zoll, CVRx, and Vifor. C. Veltmann has received honoraria for lectures and/or consulting from Abbott, Astra Zeneca, Bayer, Biotronik, BMS, Boehringer Ingelheim, Boston Scientific, CVRx, Daichii Sankyo, Medtronic, and Zoll. T.J. Pfeffer declares that he has no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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Duncker, D., Pfeffer, T.J., Bauersachs, J. et al. ECG and arrhythmias in peripartum cardiomyopathy. Herzschr Elektrophys (2021). https://doi.org/10.1007/s00399-021-00760-9

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Keywords

  • PPCM
  • Sudden cardiac death
  • Pregnancy
  • Reduced left ventricular function
  • Ventricular tachycardia

Schlüsselwörter

  • Peripartumkardiomyopathie
  • Plötzlicher Herztod
  • Schwangerschaft
  • Eingeschränkte linksventrikuläre Funktion
  • Ventrikuläre Tachykardie