Ivabradine-sensitive incessant atrial tachycardia during pregnancy: a case report

Abstract Background  Automaticity is the dominant mechanism in maternal focal atrial tachycardia (FAT) during pregnancy and if incessant, can cause tachycardia-induced cardiomyopathy. Medication failure for FATs is common, however, for the subgroup due to increased automaticity ivabradine sensitivit...

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Bibliographic Details
Published in:European heart journal : case reports 2021-10, Vol.5 (10), p.ytab367
Main Authors: Tonko, Johanna B, Douglas, Hannah, Wright, Matthew J
Format: Article
Language:English
Subjects:
Case Report
Ivabradine
Paroxysmal tachycardia
Pregnancy
Pregnant women
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Summary:Abstract Background  Automaticity is the dominant mechanism in maternal focal atrial tachycardia (FAT) during pregnancy and if incessant, can cause tachycardia-induced cardiomyopathy. Medication failure for FATs is common, however, for the subgroup due to increased automaticity ivabradine sensitivity has been described and may represent a valuable treatment option. Little data are available regarding the safety profile of ivabradine during pregnancy. Case Summary  We report the case of a 38-year-old woman with background of peripartum cardiomyopathy and incessant atrial tachycardia with deteriorating ventricular function during her second pregnancy unresponsive to betablockade and demonstrating the immediate successful rate-controlling effect of ivabradine. Discussion  Early recognition of persistent maternal FAT is essential due to its frequent association with tachycardia-mediated cardiomyopathy. Our case report highlights the challenges of providing an equally safe and effective treatment of these notoriously difficult to treat arrhythmias during pregnancy. Ivabradine in combination with a betablocker can be effective for abnormal automaticity but its safety profile during pregnancy remains uncertain.
ISSN:2514-2119
2514-2119
DOI:10.1093/ehjcr/ytab367