The investigation and management of broad complex tachycardia and ventricular standstill presenting in pregnancy: A case report

Abstract

A 23 year old pregnant lady at 35 weeks gestation presented to accident and emergency with worsening dyspnoea, palpitations and dizziness. Twelve lead electrocardiogram, routine bloods and echocardiography were normal. Ambulatory monitoring previously had shown an episode of monomorphic broad complex tachycardia (BCT) and a short episode of ventricular standstill. She was admitted for cardiac monitoring until delivery. Several episodes of ventricular standstill and self-terminating BCT were recorded, which were not associated with symptoms. The patient's symptoms either corresponded with sinus rhythm or supraventricular tachycardia. She underwent elective caesarean section at 37 weeks with no complications. The patient's symptoms reduced considerably post delivery, and she was discharged three days later. Unfortunately she then had a presyncopal episode whilst holding her baby. Due to concern regarding the safety of her baby she had a permanent pacemaker implanted to allow safe beta-blockade. She remains asymptomatic six months later.

Successful Management of Intractable Supraventricular Tachycardia in Pregnancy

“…In the case of a pregnant woman at 37 weeks AOG who had supraventricular tachycardia resistant to medical cardioversion using Adenosine following the Spanish Society of Cardiology, electric counter shock and termination of pregnancy by cesarean section was performed [14]. However, in our case, we managed her with the combination of electro-cardioversion and medical cardioversion.…”