Abstract 4142105: Impact of Supraventricular Tachycardia on Pregnancy Outcomes
Bibliographic record
Abstract
Background: Paroxysmal supraventricular tachycardia (PSVT) is one of the most common arrhythmias among pregnant women, in part due to the maternal physiological changes that occur during pregnancy. However, studies investigating the risk of new-onset and pre-existing PSVT in pregnancy, and the associated adverse maternal and fetal/neonatal outcomes are lacking. Research Questions: This study aimed to determine: 1) the proportion of women presenting with new-onset PSVT in pregnancy; 2) the impact of prior PSVT history on episode severity and management during pregnancy; and 3) the rate of adverse maternal and fetal/neonatal events among women with PSVT in pregnancy. Methods: Prospective case-control study: 77 consecutive pregnancies in 75 women referred to the St. Paul’s Hospital Cardiac Obstetric Clinic between January 2010 and January 2022 secondary to findings consistent with or a history of atrioventricular nodal re-entrant tachycardia (AVNRT) and atrioventricular re-entrant tachycardia (AVRT) PSVT without documented structural heart disease. Maternal cardiac, obstetric, and fetal/neonatal adverse events were compared to a control group consisting of 57 women with low risk, normal pregnancies and no cardiac diagnosis. Results: Among the PSVT cohort (n=77), 63 (82%) pregnancies had a prior diagnosis of PSVT and 18% were new-onset in pregnancy. Sixty-eight percent of those with a prior PSVT diagnosis had recurrence in pregnancy. Those with a more recent history (within 5 years of pregnancy) were more likely to experience PSVT during pregnancy compared to those with a more remote history (81% vs. 31%, p<0.001). Similarly, they experienced a higher frequency of PSVT during pregnancy and increased rates of chemical cardioversion (38% vs. 12%, p=0.05). There was a higher rate of adverse obstetrical events in the PSVT group vs. controls (8% vs. 0%, p=0.03), however this is likely due to higher prevalence of obstetric risk factors among the PSVT cohort. Adverse fetal/neonatal events were similar between the PSVT group vs. controls (17% vs. 19%, p=0.72). Conclusions: PSVT events were safely managed in pregnancy with no major adverse cardiac events and similar fetal/neonatal outcomes as healthy controls. However, recurrence and burden of PSVT during pregnancy is frequent and leads to management complexities among those with a history of PSVT, reinforcing the need for pre-pregnancy counselling and catheter ablation for definitive management of PSVT prior to pregnancy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".