Characteristics and outcomes of peripartum versus nonperipartum cardiomyopathy in women using a wearable cardiac defibrillator

J Card Fail. 2012 Jan;18(1):21-7. doi: 10.1016/j.cardfail.2011.09.004. Epub 2011 Oct 19.

Abstract

Background: Peripartum cardiomyopathy (PPCM) mortality rates vary between 2% and 56%, with half occurring ≤12 weeks'; postpartum. Although risk factors for PPCM have been identified, predicting sudden cardiac death among PPCM patients remains difficult. This study describes the characteristics and outcomes of PPCM patients and controls referred for a wearable cardioverter defibrillator (WCD).

Methods and results: Deidentified WCD medical orders between 2003 and 2009 and death index searches were used to characterize women (ages 17-43) with PPCM (n = 107) or matched nonpregnant women with nonischemic dilated cardiomyopathy (NIDCM; n = 159). Demographics were similar. WCD use averaged 124 ± 123 days and 96 ± 83 days among PPCM and NIDCM patients, respectively. No PPCM patients received an appropriate shock for ventricular tachycardia/ventricular fibrillation; 1 NIDCM patient received 2 successful shocks. No PPCM patient died during WCD use versus 11 concurrent NIDCM deaths. After WCD use, 3 PPCM and 13 NIDCM patients died, respectively.

Conclusions: The mortality rate of 2.8% (over 3.0 ± 1.2 years) in PPCM patients is low compared to published data. The role of WCD therapy among PPCM patients deserves further study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cardiomyopathies / mortality
  • Cardiomyopathies / physiopathology
  • Cardiomyopathies / therapy*
  • Case-Control Studies
  • Databases, Factual
  • Death, Sudden, Cardiac
  • Defibrillators*
  • Female
  • Humans
  • Maternal Mortality
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / mortality
  • Pregnancy Complications, Cardiovascular / physiopathology
  • Pregnancy Complications, Cardiovascular / therapy*
  • Puerperal Disorders / mortality
  • Puerperal Disorders / physiopathology
  • Puerperal Disorders / therapy*
  • Severity of Illness Index
  • Treatment Outcome
  • United States
  • Young Adult