Treatment of Supraventricular Tachycardia During Pregnacy with Verapamil and Cardioversion : A case Report and Review Literature.

Abstract

Background :  Paroxysmal Supraventricular Tachycardia (PSVT) is a relatively common cardiac emergency in the general population. In pergnant woman, it usually occurs in the third trimester. The untoward maternal and fetal effects of durgs should be considered before treatment during pregnacy.

Objective :  Herein is a case report of Supraventricular  tachycardia in pregnancy. To find a suitable guideline for treatment of PSVT in pregnancy, the literatures were then reiewed.

Results :  A 27 years old woman at 24 weeks gestation, presented to the emergency department with history of rapid heartbeat for approximately two hours. On admission to ICU, a narrow complex, regular supraventricular tachycardia, 180 beats/min was demonstrated. The patients was then repeatedly given two doses of veramil without any benefit. A 50 joules cardioversion was then performed and successfully converted to normal sinus rhythm. The patient had another four episodes of PSVT druing this pregnacy. She was successfully treated with verapamil and carioversion without fetal effacts in each episodes.

Conclusion :  For pregnant woman with Supraventricular tachycardia vagal stimulation maneuvers should be tried first, it this is not effective adenosine seem to be drug of choice for treating PSVT during pregnacy. However adenosine is much more expensive than verapamil and not widely available in this country, then verapamil may be considered. Cardioversion can be safetyly performed during pregnancy without adverse effexts to the fetus, however, fetal monitoring should be carried out during the procedure.

Key Words :  PSVT, Pregnancy, Cardioversion.