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

Johanna B. Tonko*, Hannah Douglas, Matthew J. Wright

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    1 Citation (Scopus)

    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.

    Original languageEnglish
    Article numberytab367
    JournalEuropean Heart Journal - Case Reports
    Volume5
    Issue number10
    DOIs
    Publication statusPublished - 1 Oct 2021

    Keywords

    • Abnormal automaticity
    • Case report
    • Focal atrial tachycardia
    • Ivabradine-sensitive atrial tachycardia
    • Peripartum cardiomyopathy
    • Tachycardia-induced cardiomyopathy

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