C70 WEARABLE CARDIOVERTER DEFIBRILLATOR IN LONG QT SYNDROME DURING PREGNANCY: TIME TO USE THE SHIELD

Abstract Introduction Long QT Syndrome (LQTS) is a rare cardiac channelopathy characterized by high risk of lethal arrhythmias. Pregnancy and post–partum period may induce an increased vulnerability, so appropriate prevention needed. Case presentation A 31–year–old primigravid woman at 36 weeks pregnancy was referred to our Cardiomyopathy Unit located in tertiary centre for LQTS screening. The patient had family history (mother brother) Brugada syndrome (cousin). 12–lead ECG (Figure 1) showed long interval (QT corrected: 508 msec), while the transthoracic echocardiogram unremarkable. genetic test performed still ongoing. reported sporadic episodes palpitations rest following 24–hour ambulatory revealed very burden polymorphic ventricular arrhythmias, with about sixteen thousand premature complexes non–sustained tachycardia. Therefore, due patient’s high–risk life–threatening arrhythmic events, metoprolol 25 mg o.d. initiated wearable cardioverter defibrillator (WCD) remote monitoring provided during labour. After 3 caesarean delivery epidural analgesia managed heart team including cardiologist, gynaecologist, obstetrician, anaesthetist close monitoring. No maternal or infant complications occurred, without detected device. WCD will be maintained also narrow follow–up patient. Discussion In pregnant patients, beta–blockers are first line therapeutic option, but they do not able interrupt arrythmias out–of–hospital setting. implantable best choice, concerns radiation exposure anaesthesia pregnancy. Moreover, lead–associated thrombosis infections were literature. ideal option these cases. It external device suited transient higher periods. it allows (figure 2) which help clinicians guiding management One drawback need continuous compliance. Finally, mandatory presence syndromes.