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@article{Sliwa:2020:10.1001/jamacardio.2019.5963,
author = {Sliwa, K and Azibani, F and Johnson, MR and Viljoen, C and Baard, J and Osman, A and Briton, O and Ntsekhe, M and Chin, A},
doi = {10.1001/jamacardio.2019.5963},
journal = {JAMA Cardiology},
pages = {458--463},
title = {Effectiveness of implanted cardiac rhythm recorders with electrocardiographic monitoring for detecting arrhythmias in pregnant women with symptomatic arrhythmia and/or structural heart disease a randomized clinical trial},
url = {http://dx.doi.org/10.1001/jamacardio.2019.5963},
volume = {5},
year = {2020}
}

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TY  - JOUR
AB  - Importance  Arrhythmias are an important cause of maternal morbidity and mortality but remain difficult to diagnose.Objective  To compare implantable loop recorder (ILR) plus 24-hour Holter electrocardiographic (ECG) monitoring with standard 24-hour Holter ECG monitoring alone in terms of acceptability, ability to identify significant arrythmias, and effect on management and pregnancy outcome in women who were symptomatic or at high risk of arrythmia because of underlying structural heart disease.Design, Setting, and Participants  This single-center, prospective randomized clinical trial recruited 40 consecutive patients from the Cardiac Disease and Maternity Clinic at Groote Schuur Hospital in Cape Town, South Africa. Pregnant patients with symptoms of arrhythmia and/or structural heart disease at risk of arrhythmia were included.Intervention  Patients were randomized to standard care (SC; 24-hour Holter ECG monitoring [n = 20]) or standard care plus ILR (SC-ILR; 24-hour Holter ECG monitoring plus ILR [n = 20]). Only 17 consented to ILR insertion, and the 3 who declined ILR were allocated to the SC group.Main Outcomes and Measures  Arrhythmias considered included atrial fibrillation, atrial flutter, premature ventricular complexes, supraventricular tachycardia, ventricular tachycardia, or ventricular fibrillation.Results  Among the 40 women in this trial, the mean (SD) age was 28.4 (5.5) years. Holter monitoring detected arrhythmias in 3 of 23 patients (13%) in the SC group and 4 of 17 patients (24%) in the SC-ILR group compared with 9 of 17 patients (53%) patients who had arrhythmias detected by ILR. Seven patients (4 with supraventricular tachycardia, 1 with premature ventricular complexes, and 2 with paroxysmal atrial fibrillation recorded by ILR) did not have arrhythmias detected by 24-hour Holter monitoring. Three of these 7 patients (43%) had a change in management as a result of their ILR recordings. There were no maternal deaths.
AU  - Sliwa,K
AU  - Azibani,F
AU  - Johnson,MR
AU  - Viljoen,C
AU  - Baard,J
AU  - Osman,A
AU  - Briton,O
AU  - Ntsekhe,M
AU  - Chin,A
DO  - 10.1001/jamacardio.2019.5963
EP  - 463
PY  - 2020///
SN  - 2380-6583
SP  - 458
TI  - Effectiveness of implanted cardiac rhythm recorders with electrocardiographic monitoring for detecting arrhythmias in pregnant women with symptomatic arrhythmia and/or structural heart disease a randomized clinical trial
T2  - JAMA Cardiology
UR  - http://dx.doi.org/10.1001/jamacardio.2019.5963
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000537129700014&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://jamanetwork.com/journals/jamacardiology/fullarticle/2761523
VL  - 5
ER  -

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