Most women with ARVC do well in pregnancy

20th January 2016

Most women with arrhythmogenic right ventricular cardiomyopathy (ARVC) tolerate pregnancy well, says a new study.

Researchers in America and the Netherlands looked at women with the condition treated at Johns Hopkins Hospital in Baltimore and on a Dutch ARVC registry. They wanted to see how the pregnancies went and how well women did afterwards.

They found 26 women with the disease who had had 39 pregnancies of more than 13 weeks gestation.

They looked at their symptoms and treatments, the success of the pregnancy and for heart failure signs and episodes of dangerous heart rhythms.

Incidences of dangerous heart rhythms (sustained ventricular arrhythmias) and heart failure were compared with rates in the women before they were pregnant. Their long-term disease was compared with 117 childbearing-age women with ARVC who had not experienced pregnancy with the condition.

For the 39 pregnancies, 16 were getting beta-blockers, six on antiarrhythmic drugs, three on diuretics and in 28 cases the woman had an internal defibrillator (ICD). Five pregnancies (13%) had one episode of a dangerous heart rhythm, including two ICD firings.

Heart failure problems, not requiring hospital admission, developed in two pregnancies (5%). All babies were born alive without major obstetric complications.

Eleven pregnancies resulted in Caesarean sections, but ten were for obstetric reasons and only one for heart failure. Beta-blockers were associated with lower birth weight but during a three-year follow-up the babies remained healthy and no mothers died nor needed a heart transplant.

Neither the presence of dangerous heart rhythms nor heart failure was significantly increased for the women during pregnancy, said the researchers.

They concluded that most pregnancies in patients with ARVC were tolerated well, but a total of 13% were complicated by dangerous heart rhythms and 5% by heart failure.

For more details see here.