HEART RHYTM DISORDERS AND THROMBOSIS. ANTICOAGULANT THERAPY OF CARDIAC ARRHYTHMIAS IN PREGNANCY
Abstract
Heart rhythm disorders during pregnancy sifnificantly increase the risk of the cardioembolism in terms of the hypercoaguability state of pregnant women. The presence of atrial fibrillation during pregnancy in conditions of additional risk factors, inculding history of stroke and thromboembolic attacks, artifial heart valves, arterial hypertension, diabetes mellitus, ischemic disease or heart failure require anticoagulant therapy during all pregnancy. Acquired or genetic forms of thrombophilia also can increase the risk of thromboembolism in women with cardiac arrhythmias during pregnancy.
About the Authors
A. D. Makatsariya
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation
Russian Federation
MD, corresponding member of the Russian Academy of Sciences, Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Medical and Preventive, First Moscow State Medical Sechenov University. Address: ul. Trubetskaya, 8, str. 2, Moskva, Russia, 119048. Tel.: +7(495)7885840
S. V. Akinshina
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation
Russian Federation
PhD, research associate of the Ob/Gyn Department of The First Moscow State Medical Sechenov University. Address: ul. Zemlyanoi Val, 62-1, Moscow, Russia, 109004. Tel.: +7(495)7885840
V. O. Bitsadze
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation
Russian Federation
MD, Professor, Department of Obstetrics and Gynecology, Faculty of Medical and Preventive, First Moscow State Medical Sechenov University. Address: ul. Trubetskaya, 8, str. 2, Moskva, Russia, 119048. Tel.: +7(495)7885840
References
1. Albers G.W., Diener H.C., Frison L., Grind M., Nevinson M., Partridge S., Halperin J.L., Horrow J., Olsson S.B., Petersen P., Vahanian A. SPORTIF Executive Steering Committee for the SPORTIF V Investigators. Ximelagatran vs warfarin for stroke prevention in patients with nonvalvular atrial fibrillation: a randomized trial. JAMA. 2005 Feb 9; 293 (6): 690-8.
2. Amouyel P., Mismetti P., Langkilde L.K., Jasso-Mosqueda G., Nelander K., Lamarque H. INR variability in atrial fibrillation: a risk model for cerebrovascular events. Eur J Intern Med. 2009 Jan; 20 (1): 63-9.
3. Bogousslavsky J., Van Melle G., Regli F., Kappenberger L. Pathogenesis of anterior circulation stroke in patients with nonvalvular atrial fibrillation: the Lausanne Stroke Registry. Neurology. 1990 Jul; 40 (7): 1046-50.
4. Brodsky M., Doria R., Allen B., Sato D., Thomas G., Sada M. New-onset ventricular tachycardia during pregnancy. Am Heart J. 1992 Apr; 123 (4 Pt 1): 933-41.
5. Camm A.J., Lip G.Y., De Caterina R., Savelieva I., Atar D., Hohnloser S.H., Hindricks G., Kirchhof P. ESC Committee for Practice Guidelines-CPG; Document Reviewers. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation-developed with the special contribution of the European Heart Rhythm Association. Europace. 2012 Oct; 14 (10): 1385-413.
6. Cohen H., O’Brien P (eds). Disorders of thrombosis and Haemostasis in Pregnancy. Springer-Verlag. London. 2012.
7. Connolly S.J., Ezekowitz M.D., Yusuf S., Eikelboom J., Oldgren J., Parekh A., Pogue J., Reilly P.A., Themeles E., Varrone J., Wang S., Alings M., Xavier D., Zhu J., Diaz R., Lewis B.S., Darius H., Diener H.C., Joyner C.D., Wallentin L. RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009 Sep 17; 361 (12): 1139-51.
8. Cuthill J.A., Young S., Greer I.A., Oldroyd K. Anaesthetic considerations in a parturient with critical coronary artery disease and a drugeluting stent presenting for caesarean section. Int J Obstet Anesth. 2005 Apr; 14 (2): 167-71.
9. Dempfle C.E. Direct oral anticoagulants--pharmacology, drug interactions, and side effects. Semin Hematol. 2014 Apr; 51 (2): 89-97.
10. Diller G.P., Gatzoulis M.A. Pulmonary vascular disease in adults with congenital heart disease. Circulation. 2007 Feb 27; 115 (8): 1039-50.
11. Drenthen W., Pieper P.G., Roos-Hesselink J.W., van Lottum W.A., Voors A.A., Mulder B.J., van Dijk A.P., Vliegen H.W., Yap S.C., Moons P., Ebels T., van Veldhuisen D.J. ZAHARA Investigators. Outcome of pregnancy in women with congenital heart disease: a literature review. J Am Coll Cardiol. 2007 Jun 19; 49 (24): 2303-11.
12. Eikelboom J.W., Weitz J.I. 'Realworld' use of non-vitamin K antagonist oral anticoagulants (NOACs): Lessons from the Dresden NOAC Registry. Thromb Haemost. 2015 Jun; 113 (6): 1159-61.
13. Feinberg W.M., Cornell E.S., Nightingale S.D., Pearce L.A., Tracy R.P., Hart R.G., Bovill E.G. Relationship between prothrombin activation fragment F1.2 and international normalized ratio in patients with atrial fibrillation. Stroke Prevention in Atrial Fibrillation Investigators. Stroke. 1997 Jun; 28 (6): 1101-6.
14. Fox K.A., Piccini J.P., Wojdyla D., Becker R.C., Halperin J.L., Nessel C.C., Paolini J.F., Hankey G.J., Mahaffey K.W., Patel M.R., Singer D.E., Califf R.M. Prevention of stroke and systemic embolism with rivaroxaban compared with warfarin in patients with non-valvular atrial fibrillation and moderate renal impairment. Eur Heart J. 2011 Oct; 32 (19): 2387-94.
15. Furberg C.D., Psaty B.M., Manolio T.A., Gardin J.M., Smith V.E., Rautaharju P.M. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol. 1994 Aug 1; 74 (3): 236-41.
16. Greer I.A. Thrombosis in pregnancy: maternal and fetal issues. Lancet. 1999 Apr 10; 353 (9160): 1258-65.
17. Haft J.I. Stroke prevention in atrial fibrillation: impact of novel oral anticoagulants. Clin Appl Thromb Hemost. 2013 Jun; 19(3): 241-8.
18. Hart R.G., Benavente O., Pearce L.A. Increased risk of intracranial hemorrhage when aspirin is combined with warfarin: A meta-analysis and hypothesis. Cerebrovasc Dis. 1999 Jul-Aug; 9 (4): 215-7.
19. Hart R.G., Pearce L.A., Aguilar M.I. Metaanalysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007 Jun 19; 146 (12): 857-67.
20. Hart R.G., Pearce L.A., Rothbart R.M., McAnulty J.H., Asinger R.W., Halperin J.L. Stroke with intermittent atrial fibrillation: incidence and predictors during aspirin therapy. Stroke Prevention in Atrial Fibrillation Investigators. J Am Coll Cardiol. 2000 Jan; 35 (1): 183-7.
21. Heppell R.M., Berkin K.E., McLenachan J.M., Davies J.A. Haemostatic and haemodynamic abnormalities associated with left atrial thrombosis in non-rheumatic atrial fibrillation. Heart. 1997 May; 77 (5): 407-11.
22. Hohnloser S.H., Hijazi Z., Thomas L., Alexander J.H., Amerena J., Hanna M., Keltai M., Lanas F., Lopes R.D., Lopez-Sendon J., Granger C.B., Wallentin L. Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atrial fibrillation: insights from the ARISTOTLE trial. Eur Heart J. 2012 Nov; 33 (22): 2821-30.
23. January C.T., Wann L.S., Alpert J.S., Calkins H., Cigarroa J.E., Cleveland J.C. Jr., Conti J.B., Ellinor P.T., Ezekowitz M.D., Field M.E., Murray K.T., Sacco R.L., Stevenson W.G., Tchou P.J., Tracy C.M., Yancy C.W. American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014 Dec 2; 64 (21): e1-76.
24. Liao J., Khalid Z., Scallan C., Morillo C., O'Donnell M. Noninvasive cardiac monitoring for detecting paroxysmal atrial fibrillation or flutter after acute ischemic stroke: a systematicreview. Stroke. 2007 Nov; 38 (11): 2935-40.
25. Lip G.Y., Beevers M., Churchill D., Shaffer L.M., Beevers D.G. Effect of atenolol on birth weight. Am J Cardiol. 1997 May 15; 79 (10): 1436-8.
26. Lip G.Y., Lowe G.D., Rumley A., Dunn F.G. Fibrinogen and fibrin D-dimer levels in paroxysmal atrial fibrillation: evidence for intermediate elevated levels of intravascular thrombogenesis. Am Heart J. 1996 Apr; 131 (4): 724-30.
27. Lip G.Y., Nieuwlaat R., Pisters R., Lane D.A., Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010 Feb; 137 (2): 263-72.
28. Olsson S.B. Executive Steering Committee of the SPORTIF III Investigators. Stroke prevention with the oral direct thrombin inhibitor ximelagatran compared with warfarin in patients with non-valvular atrial fibrillation (SPORTIF III): randomised controlled trial. Lancet. 2003 Nov 22; 362 (9397): 1691-8.
29. Palareti G. Direct oral anticoagulants and bleeding risk (in comparison to vitamin K antagonists and heparins), and the treatment of bleeding. Semin Hematol. 2014 Apr; 51 (2): 102-11.
30. Pisters R., Lane D.A., Nieuwlaat R., de Vos C.B., Crijns H.J., Lip G.Y. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010 Nov; 138 (5): 1093-100.
31. Presbitero P., Somerville J., Stone S., Aruta E., Spiegelhalter D., Rabajoli F. Pregnancy in cyanotic congenital heart disease. Outcome of mother and fetus. Circulation. 1994 Jun; 89 (6): 2673-6.
32. Rashba E.J. Zareba W., Moss A.J., Hall W.J., Robinson J., Locati E.H., Schwartz P.J., Andrews M. Influence of pregnancy on the risk for cardiac events in patients with hereditary long QT syndrome. LQTS Investigators. Circulation. 1998 Feb 10; 97 (5): 451-6.
33. Senoo K., Lip G.Y. Comparative efficacy and safety of the non-vitamin K antagonist oral anticoagulants for patients with nonvalvular atrial fibrillation. Semin Thromb Hemost. 2015 Mar; 41 (2): 146-53.
34. Siu S.C., Sermer M., Colman J.M., Alvarez A.N., Mercier L.A., Morton B.C., Kells C.M., Bergin M.L., Kiess M.C., Marcotte F., Taylor D.A., Gordon E.P., Spears J.C., Tam J.W., Amankwah K.S., Smallhorn J.F., Farine D., Sorensen S. Cardiac Disease in Pregnancy (CARPREG) Investigators. Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation. 2001 Jul 31; 104 (5): 515-21.
35. Steffel J., Luscher T.F. Vitamin K antagonists. Ready to be replaced? Hamostaseologie. 2012; 32 (4): 249-57.
36. Stroke Risk in Atrial Fibrillation Working Group. Comparison of 12 risk stratification schemes to predict stroke in patients with nonvalvular atrial fibrillation. Stroke. 2008 Jun; 39 (6): 1901-10.
37. Tawam M., Levine J., Mendelson M., Goldberger J., Dyer A., Kadish A. Effect of pregnancy on paroxysmal supraventricular tachycardia. Am J Cardiol. 1993 Oct 1; 72 (11): 838-40.
38. Varma C., Warr M.R., Hendler A.L., Paul N.S., Webb G.D., Therrien J. Prevalence of "silent" pulmonary emboli in adults after the Fontan operation. J Am Coll Cardiol. 2003 Jun 18; 41 (12): 2252-8.
39. Wolf P.A., D'Agostino R.B., Belanger A.J., Kannel W.B. Probability of stroke: a risk profile from the Framingham Study. Stroke. 1991 Mar; 22 (3): 312-8.
Review
For citations:
Makatsariya A.D., Akinshina S.V., Bitsadze V.O. HEART RHYTM DISORDERS AND THROMBOSIS. ANTICOAGULANT THERAPY OF CARDIAC ARRHYTHMIAS IN PREGNANCY. Obstetrics, Gynecology and Reproduction. 2016;10(1):50-61. (In Russ.) https://doi.org/10.17749/2313-7347.2015.10.1.050-061
Views: 501
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Email this article 
