title: Cardiac arrhythmias in pregnancy.
abstract: As more women with repaired congenital heart disease survive to their reproductive years and many other women are delaying pregnancy until later in life, a rising concern is the risk of cardiac arrhythmias during pregnancy. Naturally occurring cardiovascular changes during pregnancy increase the likelihood that a recurrence of a previously experienced cardiac arrhythmia or a de novo arrhythmia will occur. Arrhythmias should be thoroughly investigated to determine if there is a reversible etiology, and risks/benefits of treatment options should be fully explored. We discuss the approach to working up and treating various arrhythmias during pregnancy with attention to fetal and maternal risks as well as treatment of fetal arrhythmias. Acute management in stable patients includes close monitoring and intravenous pharmacologic therapy, while DC cardioversion should be used to terminate arrhythmias in hemodynamically unstable patients. Long-term management may require continued oral antiarrhythmic therapy, with particular attention to fetal safety, to prevent complications associated with arrhythmias.
authors.affiliation: Department of Medicine, Columbia University Medical Center, 161 Fort Washington Ave, Suite 648, New York, NY 10032.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Knotts
authors.affiliation: Department of Medicine, Columbia University Medical Center, 161 Fort Washington Ave, Suite 648, New York, NY 10032. Electronic address: hg2017@columbia.edu.
authors.forename: Hasan
authors.initials: H
authors.lastname: Garan
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005318:Fetal Heart / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D008991:Monitoring, Physiologic; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology / Q000628:therapy*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D018570:Risk Assessment
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: antiarrhythmic drugs; cardiac arrhythmia; fetal arrhythmia; pregnancy