Prosthetic heart valves and arrhythmias in pregnancy.
The majority of women with bioprosthetic valves do not require anticoagulation during pregnancy. In women with mechanical valves, a detailed discussion of the advantages and disadvantages of the three anticoagulant options (warfarin, unfractionated heparin and low molecular weight heparin) is indicated. The majority of women with arrhythmias during pregnancy have a benign increased rate of atrial or ventricular premature beats. Those women who are hemodynamically stable can be reassured and do not usually require treatment. Women with more ominous arrhythmias should be managed in collaboration with a cardiologist, usually using the same agents that would be chosen in the non-pregnant patient, including electrical cardioversion when necessary. This is the fifth and final article in a series reviewing in detail the assessment and management of specific cardiac disorders in pregnancy.
Davies
Gregory A L
GA
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Queen's University, Kingston ON, Canada.
Herbert
William N P
WN
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D001705:Bioprosthesis; D004554:Electric Countershock; D005260:Female; D006349:Heart Valve Diseases / Q000188:drug therapy*; D006350:Heart Valve Prosthesis; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin