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Comment & Response
August 26, 2020

Interpreting the Need for Implantable Loop Recorder Monitoring in Pregnant Women at High Risk of Arrhythmias—Reply

Author Affiliations
  • 1Cardiology, University of Cape Town, Cape Town, South Africa
  • 2Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
  • 3University of Cape Town, Cape Town, South Africa
JAMA Cardiol. 2020;5(11):1304-1305. doi:10.1001/jamacardio.2020.3545

In Reply We thank Ahmad and colleagues for their letter regarding our article.1 Evidence for best practices in the diagnosis and management of arrhythmias in pregnant and peripartum women relies predominantly on case reports, retrospective studies, registries, and expert opinion.2,3 Detection of arrhythmias can be challenging when they are paroxysmal and infrequent. The implantable loop recorder (ILR) has now been shown to be effective in detecting and quantifying the burden of cardiac arrhythmias in almost all populations where they have been studied,4 including, now, pregnant patients.1 The reported incidence of arrhythmias in pregnancy and the peripartum period is likely underestimated, as arrhythmias were diagnosed on electrocardiography or 24-hour Holter monitoring.

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