Right ventricular outflow tract tachycardia worsened during pregnancy

Kambiré, Yibar; Konaté, Lassina; Millogo, Georges Rosario Christian; Sib, Elodie; Amoussou, Myriam; Nébié, L. V. A.; Niakara, A.

doi:10.11604/pamj.2015.20.60.5864

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…RVOT tachycardia is the most common form of idiopathic ventricular tachycardia, which may occur in the absence of structural heart disease 24,30 . It is suggested that high level endurance exercise training 14,27 and pregnancy 31 may provoke idiopathic RVOT tachycardia. Yet, RVOT tachycardia can also occur in patients with ARVC/D 14,32 .…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic Changes in the Right Ventricle Induced by Variations of Cardiac Output: A Possible Mechanism for Arrhythmia Occurrence in the Outflow Tract

Gülan

Saguner

Akdiş

et al. 2019

Sci Rep

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The rationale of this paper is to investigate right ventricular (RV) hemodynamics in relation to changes in cardiac output, and in particular to study exercise-induced stresses at the RV outflow tract (RVOT), which is a common site of ventricular arrhythmias in the athlete’s heart. We hypothesize that the thin-walled RVOT is exposed to high wall shear stresses (WSS) during physiological states associated with high cardiac output such as exercise, and therefore, may be particularly prone to substrate formation leading to ventricular tachyarrhythmias. 3D Particle Tracking Velocimetry (3D-PTV), an optical imaging method, has been performed in a novel anatomically accurate compliant silicone right heart model derived from a high resolution MRI heart scan of a healthy male proband. RV and RVOT flow patterns at resting conditions were obtained from two healthy athletic male proband’s hearts and two patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) via phase contrast magnetic resonance imaging (PC-MRI). The healthy case was used as a reference for validating the in vitro flow patterns of the silicone model, while the diseased cases were used to generalize our findings and investigate possible changes in hemodynamic stresses with RV morphological remodelling. Our results showed that both healthy and diseased geometries consistently displayed an increased WSS in the RVOT relative to the rest of the RV. We found that increases in cardiac output may lead to increases of mean kinetic energy (MKE), laminar viscous dissipation and WSS at the RVOT. Furthermore, higher peak WSS magnitudes were found for the diseased cases. The identified high WSS regions may correlate with the common site of RVOT ventricular tachycardia in athletes and patients with ARVC/D. Our results imply that exercise, as well as anatomical and functional remodeling might alter RV wall shear stress both in magnitude and spatial distribution, leading to increased hemodynamic stresses in the RVOT.

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Section: Discussionmentioning

confidence: 99%

Hemodynamic Changes in the Right Ventricle Induced by Variations of Cardiac Output: A Possible Mechanism for Arrhythmia Occurrence in the Outflow Tract

Gülan

Saguner

Akdiş

et al. 2019

Sci Rep

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“…The increase in the heart rate could be due to stress, sympathetic stimulation, or hormonal phenomena during pregnancy [ 22 ]. Kambire et al reported a case of right ventricular outflow tract tachycardia that worsened during pregnancy, suggesting that ventricular tachycardia may be exacerbated by pregnancy, with the cause ranging from congenital heart disease to peripartum cardiomyopathy [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Case Report of S1Q3T3 Electrocardiographic Abnormality in a Pregnant Asthmatic Patient During Acute Bronchospasm

2017

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Patient: Female, 33Final Diagnosis: S1Q3T3 electrocardiographic abnormality in a pregnant asthmatic during acute bronchospasmSymptoms: Cough • shortness of breathMedication: —Clinical Procedure: EKGSpecialty: PulmonologyObjective:Rare co-existance of disease or pathologyBackground:Asthma is the most common chronic pulmonary disease during pregnancy. Several previous reports have documented reversible electrocardiographic changes during severe acute asthma attacks, including tachycardia, P pulmonale, right bundle branch block, right axis deviation, and ST segment and T wave abnormalities.Case Report:We present the case of a pregnant patient with asthma exacerbation in which acute bronchospasm caused S1Q3T3 abnormality on an electrocardiogram (ECG). The complete workup of ECG findings of S1Q3T3 was negative and correlated with bronchospasm. The S1Q3T3 electrocardiographic abnormality can be seen in acute bronchospasm in pregnant women. The other causes like pulmonary embolism, pneumothorax, acute lung disease, cor pulmonale, and left posterior fascicular block were excluded.Conclusions:Asthma exacerbations are of considerable concern during pregnancy due to their adverse effect on the fetus, and optimization of asthma treatment during pregnancy is vital for achieving good outcomes. Prompt recognition of electrocardiographic abnormality and early treatment can prevent adverse perinatal outcomes.

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2023 HRS expert consensus statement on the management of arrhythmias during pregnancy

et al. 2023

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Right ventricular outflow tract tachycardia worsened during pregnancy

Cited by 3 publications

References 10 publications

Hemodynamic Changes in the Right Ventricle Induced by Variations of Cardiac Output: A Possible Mechanism for Arrhythmia Occurrence in the Outflow Tract

Hemodynamic Changes in the Right Ventricle Induced by Variations of Cardiac Output: A Possible Mechanism for Arrhythmia Occurrence in the Outflow Tract

Case Report of S1Q3T3 Electrocardiographic Abnormality in a Pregnant Asthmatic Patient During Acute Bronchospasm

2023 HRS expert consensus statement on the management of arrhythmias during pregnancy

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