Taiwan: High premature ventricular complex (PVC) burden is not linked to unfavorable maternal and neonatal outcomes without need for antiarrhythmic drugs (AADs) therapy in pregnant women having structurally normal heart, researchers state in a study published in International Journal of Cardiology.
High PVC burden is reported to increase the risk of all-cause mortality and left ventricular dysfunction. Hao-Tien Liu, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan, and colleagues aimed to examine neonatal and maternal outcomes of pregnant women having structurally normal heart having PVC burden ≥1% in a retrospective cohort study.

For this purpose, the researchers used data from Chang Gung Research Database. The researchers identified pregnant women with documented maternal PVC burden ≥1% by 24-h Holter monitor from January 1, 2005, through June 30, 2020. Women with pregnancy diagnosed with structural heart disease or arrhythmias other than PVC were excluded. Propensity score matching (PSM) was used for covariates balancing between the PVC group and normal control group. The PVC group was divided into low-PVC (< 10%) and high-PVC burden subgroups. Assessment of maternal and neonatal outcomes was done through 6 months after delivery or termination.
The study led to the following findings:
· After PSM, there were 214, 61, and 46 pregnant women enrolled in the normal control group, low-PVC burden, and high-PVC burden subgroups, respectively.
· The high-PVC and low-PVC burden subgroups had composite adverse maternal and neonatal events similar to the control group without use of antiarrhythmic drugs (AADs), but a higher proportion of placental abruption was observed in the high-PVC burden subgroup.
· Maternal age, diabetes, and overweight were significant predictors of composite adverse maternal events, whereas only maternal age was a significant predictor of composite adverse neonatal events.
To conclude, the maternal and neonatal outcomes in pregnant women with frequent premature ventricular complexes and structurally normal heart was similar to the normal control group. Also, there is no need of anti-arrhythmic drugs therapy in pregnant women having structurally normal heart unless premature ventricular complexes are problematic.
"Higher body mass index, advanced maternal age, and diabetes mellitus are associated independently with unfavorable maternal events; and advanced maternal age is an independent predictor of advers neonatal events," the researchers wrote in their study. "High premature ventricular complex burden is not a significant factor linked with composite adverse maternal or neonatal events."
Reference:
The study titled, "Obstetric and fetal/neonatal outcomes in pregnant women with frequent premature ventricular complexes and structurally normal heart," was published in the International Journal of Cardiology.
DOI: https://doi.org/10.1016/j.ijcard.2022.10.011