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      Síndrome de Wolff Parkinson White y embarazo

      case-report

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          Abstract

          El embarazo se asocia a un incremento en la incidencia de diversas arritmias. A propósito de dos casos clínicos de pacientes con síndrome de Wolff Parkinson White se presenta una revisión en el tratamiento agudo y crónico de la arritmia con fármacos antiarrítmicos y/o cardioversión eléctrica, así como la conducta obstétrica a seguir.

          Translated abstract

          Summary Pregnancy is associated to an increase in the incidence of several arrhythmias. A review of acute and chronic treatment of arrhythmias with anti- arrhythmic drugs and/or electric cardioversion and the obstetric conduct to be followed is presented in this study, based on two clinical cases of patients suffering from Wolff Parkinson White syndrome

          Translated abstract

          Resumo A gravidez está associada a um aumento da incidência de arritmias. Apresentamos dois casos de pacientes com síndrome de Wolff Parkinson White e uma revisão do tratamento agudo e crônico da arritmia com fármacos antiarrítmicos e/ou cardioversao elétrica e da conduta obstétrica recomendada.

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          Most cited references17

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          The impact of maternal cardioversion on fetal haemodynamics.

          Hsien-Chung Yu, Chi-Long Chen, Her-Young Su … (2006)
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            Acute therapy of maternal and fetal arrhythmias during pregnancy.

            Hans-Joachim Trappe (2016)
            Atrial premature beats are frequently diagnosed during pregnancy. Supraventricular tachycardia (atrial tachycardia, atrioventricular nodal reentrant tachycardia, circus movement tachycardia) is diagnosed less frequently. For acute therapy, electrical cardioversion with 50 to 100 J is indicated in all unstable patients. In stable supraventricular tachycardia, the initial therapy includes vagal maneuvers to terminate tachycardias. For short-term management, when vagal maneuvers fail, intravenous adenosine is the first choice drug and may safely terminate the arrhythmia. Ventricular premature beats are also frequently present during pregnancy and are benign in most patients; however, malignant ventricular tachyarrhythmias (sustained ventricular tachycardia, ventricular flutter, or ventricular fibrillation) may occur. Electrical cardioversion is necessary in all patients who are hemodynamically unstable with life-threatening ventricular tachyarrhythmias. In hemodynamically stable patients, initial therapy with ajmaline, procainamide, or lidocaine is indicated. In patients with syncopal ventricular tachycardia, ventricular fibrillation, ventricular flutter, or aborted sudden death, an implantable cardioverter-defibrillator is indicated. In patients with symptomatic bradycardia, a pacemaker can be implanted using echocardiography at any stage of pregnancy. The treatment of the pregnant patient with cardiac arrhythmias requires important modifications of the standard practice of arrhythmia management. The goal of therapy is to protect the patient and fetus through delivery, after which chronic or definitive therapy can be administered.
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              Arritmias en el embarazo: ¿Cómo y cuándo tratar?

              Jorge R Gómez Flores, Manlio Márquez (2007)
              El embarazo puede favorecer la presencia de arritmias cardíacas que no se habían presentado previamente en individuos aparentemente sanos. Los factores que potencialmente pueden promover la presencia de arritmias en el embarazo y durante la labor y el parto se atribuyen a los efectos electrofisiológicos cardíacos directos de las hormonas, cambios en el tono autonómico, alteraciones hemodinámicas, hipokalemia del embarazo y enfermedad cardíaca subyacente. Tanto la taquicardia paroxística supraventricular como la taquicardia ventricular, pueden causar compromiso hemodinámico con consecuencias para el feto. Usualmente ningún fármaco es necesario para el manejo de extrasístoles supraventriculares o ventriculares, pero los estimulantes potenciales, como tabaco, cafeína y alcohol deben de suspenderse. En la taquicardia paroxística supraventricular, primero deben intentarse maniobras de estimulación vagal. En mujeres embarazadas con fibrilación auricular, el objetivo del tratamiento es la conversión a ritmo sinusal o el control de la frecuencia ventricular con un betabloqueador cardioselectivo o digoxina. Las arritmias ventriculares pueden presentarse en las mujeres embarazadas con miocardiopatía, cardiopatía congénita, cardiopatía valvular o prolapso de la válvula mitral. La amiodarona no es segura para el feto. El tratamiento con betabloqueadores puede continuarse durante el embarazo y el postparto en mujeres con síndrome de QT largo y torsade de pointes.
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                Author and article information

                Contributors
                Leticia Luchinetti: Role: ND
                Gabriel Parma: Role: ND
                Margarita Escardó: Role: ND
                Gonzalo Sotero: Role: ND
                Journal
                Journal ID (publisher): rmu
                Title: Revista Médica del Uruguay
                Abbreviated Title: Rev. Méd. Urug.
                Publisher: Sindicato Médico del Uruguay (Montevideo )
                ISSN: 1688-0390
                Publication date (Print): December 2011
                Volume: 27
                Issue: 4
                Pages: 265-271
                Affiliations
                [1 ] Universidad de la República.Facultad de Medicina Uruguay
                [2 ] Universidad de la República.Facultad de Medicina Uruguay
                [3 ] Universidad de la República.Facultad de Medicina Uruguay
                [4 ] Universidad de la República. Facultad de Medicina Uruguay
                Article
                Publisher ID: S1688-03902011000400007
                SO-VID: 36792726-cd01-4c16-bb7f-4a6f5989419b
                License:

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Uruguay

                Self URI (journal page): http://www.scielo.edu.uy/scielo.php?script=sci_serial&pid=1688-0390&lng=en
                Categories
                Subject: MEDICAL LABORATORY TECHNOLOGY
                Subject: MEDICINE, GENERAL & INTERNAL
                Subject: MEDICINE, LEGAL
                Subject: MEDICINE, RESEARCH & EXPERIMENTAL
                Subject: ONCOLOGY
                Subject: SURGERY

                ScienceOpen disciplines: Oncology & Radiotherapy,Social law,Medicine,Surgery,Clinical chemistry,Internal medicine
                Keywords: EMBARAZO,WOLFF-PARKINSON-WHITE SYNDROME,PREGNANCY,SÍNDROME DE WOLFF-PARKINSON-WHITE
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy, Social law, Medicine, Surgery, Clinical chemistry, Internal medicine
                Keywords: EMBARAZO, WOLFF-PARKINSON-WHITE SYNDROME, PREGNANCY, SÍNDROME DE WOLFF-PARKINSON-WHITE

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