Veld, J. de (Jolien) (2021) Childbirth with an active implantable cardioverter defibrillator: a safe combination. thesis, Medicine.
Full text available on request.Abstract
Rationale: The use of implantable cardioverter defibrillators (ICDs) for women with congenital heart diseases continues to increase, leading to more women becoming pregnant with an ICD in situ. There are no guidelines for childbirth with an ICD. ICDs are often deactivated during childbirth as a result of the hypothetical risk for inappropriate shocks (IAS) caused by oversensing of uterine contractions. This study hypothesized that it is safe to leave the ICD in active mode. Methods: We retrospectively included female ICD patients between 18-60 years old, from the Amsterdam University Medical Centers in The Netherlands. Inclusion criteria were vaginal delivery after > 20 weeks of amenorrhea, and ICD in situ. Data about their cardiac disease, pregnancy, and childbirth were collected, as well as a questionnaire that asked about their childbirth experiences. Primary outcomes were IAS during childbirths with an active ICD, and non-ICD therapy (external defibrillation or medication) for rhythm disturbances during childbirths with an inactive ICD. For the secondary outcome, patients were divided in an ICD-on and an ICD-off group. The difference in rate of satisfaction about their ICD status during childbirth between these groups was evaluated. Results: During a total of 41 deliveries, there were no episodes of IAS and no external defibrillations or cardiac medications given. Twenty-six women were included, of whom 13 had at least once given birth with an active ICD. Significantly more patients in the ICD-off group would like their ICD status to be different (on) if they would give birth again, compared to the ICD-on group (p=0.002). Conclusion: Our results show that it is safe to give birth with an active ICD and this can be advised to the patient. Shared decision making should be used to meet patient specific needs.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Lemmert, M.E. and Knops, R.E. and Stuijt, W. van der |
| Faculty: | Medical Sciences |
| Date Deposited: | 05 Jan 2022 10:50 |
| Last Modified: | 05 Jan 2022 10:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2938 |
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