title: Maternal arrhythmia: a case report and review of the literature.
abstract: Pregnant patients with maternal arrhythmias can be challenging and difficult to treat. Medication choices may be limited in patients who are pregnant. Pregnancy carries with it a unique and complex physiology, coupled with fetal concerns. We describe a pregnant patient with an arrhythmia to illustrate treatment thought process and options. We also present a comprehensive review of the literature in regard to treatment of maternal arrhythmias and their potential adverse fetal and maternal outcomes. These treatments include antiarrhythmic medications, electrical cardioversion, and radiofrequency ablation. Antepartum and intrapartum monitoring will also be addressed along with delivery planning and postpartum considerations. The most important aspect in treating these patients is the use of a multidisciplinary approach. The decision of what therapy to use must be addressed on a case-by-case basis with special attention to the patient's individual issues and concerns.
  
  
  BACKGROUND
  Obstetricians and gynecologists, family physicians, emergency room physicians
  
  
  OBJECTIVE
  After completion of this educational activity, the obstetrician/gynecologist should be better able to assess and council patients on the risks and complications of maternal arrhythmias in pregnancy. Evaluate the current treatment options available for health care providers caring for pregnant patients with maternal arrhythmia, and manage the antepartum course, labor, and delivery in these patients.
authors.affiliation: College of Medicine, Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL 33606, USA. jmoore@health.usf.edu
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Moore
authors.forename: Patrick
authors.initials: P
authors.lastname: Teefey
authors.forename: Kiran
authors.initials: K
authors.lastname: Rao
authors.forename: Michael S
authors.initials: MS
authors.lastname: Berlowitz
authors.forename: Sanders H
authors.initials: SH
authors.lastname: Chae
authors.forename: Jerome
authors.initials: J
authors.lastname: Yankowitz
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000628:therapy*; D017115:Catheter Ablation; D036861:Delivery, Obstetric; D004554:Electric Countershock; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology / Q000628:therapy*
chemical_list: D000889:Anti-Arrhythmia Agents