Management of Long QT Syndrome in Women Before, During, and After Pregnancy

Abstract

Congenital long QT syndrome (LQTS) is a primary genetic and electrical disorder that increases risk for torsades de pointes, syncope, and sudden death. Post-pubertal women with LQTS require specialized multidisciplinary management before, during, and after pregnancy involving cardiology and obstetrics to reduce risk for cardiac events in themselves and their fetuses and babies. The risk of potentially life-threatening events is lower during pregnancy but increases significantly during the 9-month postpartum period. Treatment of women with LQTS with a preferred β-blocker at optimal doses along with close monitoring are indicated throughout pregnancy and during the high-risk postpartum period.

Preventing and Treating Torsades de Pointes in the Mother, Fetus and Newborn in the Highest Risk Pregnancies with Inherited Arrhythmia Syndromes

“…Prenatal and delivery room care of adult women with Long QT Syndrome (LQTS) has been described [1][2][3][4][5][6][7][8], but less has been written about the assessment and management of Long QT Syndrome in the fetus presenting with severe LQTS-related arrhythmias [1,9]. It is possible to provide risk mitigation during pregnancy and delivery [8].…”

“…Mothers with symptoms on medications with or without ICD It is important to risk-stratify the pregnancy. Mothers with LQTS or other ion channelopathy require ongoing assessment throughout pregnancy, in the delivery room, and especially in the post-partum period, up to nine months post-delivery [1][2][3][4][5][6][7][8].…”