Hội Tim mạch học Việt Nam

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AVNRT: Termination with adenosine

1 of 5 17-year-old pregnant female with palpitations and syncope

3 of 5 After 6 months on flecainide

5 of 5 6 weeks postpartum

Anatomical position of RVOT / LVOT

Ouyang et al J Am Coll Cardiol 2002;39:500-508

V2 V1

V5

24 year old pregnant female

Left Fascicular System

Tawara

Anticoagulation during Pregnancy

1 Mitral stenoses

2 Artificial valve

3 Previous cerebrovascular event

MS 2010

Anticoagulant Therapy during

Pregnancy

1 Coumadin absolute contraindication in 1st trimester (coumadin embryopathy)

2 CNS abnormalities and bleeding reported beyond 1st trimester

3 Heparin (does not cross placenta) – 35,000 units twice

daily titrated to activated PTT 1.5 x normal

4 LMW Heparin 100 units s.c twice daily (b.i.d.)

5 Discontinue heparin 12 hours before labor induction

Anticoagulants in Pregnancy in Patients

with Artificial Heart Valves

1 Heparin failure has been reported

2 American College of Cardiology (ACC) options:

a Heparin or LMW Heparin throughout pregnancy

b Warfarin throughout pregnancy

c Heparin during 1st trimester with switch to

warfarin in 2nd trimester