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Review
. 2024 Mar 14;20(2):36-50.
doi: 10.14797/mdcvj.1325. eCollection 2024.

An Overview of Arrhythmias in Pregnancy

Kamala P Tamirisa  1 , Estefania Oliveros  2 , Shweta Paulraj  3 , Adriana C Mares  4 , Annabelle Santos Volgman  5
Affiliations
Review

An Overview of Arrhythmias in Pregnancy

Kamala P Tamirisa et al. Methodist Debakey Cardiovasc J. .

Abstract

Cardiovascular disease significantly jeopardizes pregnancies in the United States, impacting 1% to 4% of pregnancies annually. Among complications, cardiac arrhythmias are prevalent, posing concerns for maternal and fetal health. The incidence of arrhythmias during pregnancy is rising, partly due to advances in congenital heart surgery and a growing population of women with structural heart disease. While most arrhythmias are benign, the increasing prevalence of more serious arrhythmias warrants a proactive approach. Guidance and reassurance suffice in many cases, but persistent symptoms require cautious use of antiarrhythmic drugs or other therapies for a safe outcome. Managing more serious arrhythmias requires a comprehensive, multidisciplinary approach involving specialists, including maternal-fetal medicine physicians, cardiologists, electrophysiologists, and anesthesiologists.

Keywords: antiarrhythmic; cardio-obstetrics; maternal arrhythmias; pregnancy.

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Conflict of interest statement

Kamala Tamirisa is on the Speakers Bureau for Abbott and Sanofi; Estefania Oliveros is funded by a research grant from Johnson and Johnson; Annabelle Santos Volgman is a consultant for Sanofi, Pfizer, Janssen, Novartis, and NIH Clinical Trials and holds stock in Apple, Inc. The other authors have no competing interests to declare.

Figures

Management of pregnant patients with paroxysmal supraventricular tachycardia and AF
Figure 1
General management of pregnant patients with paroxysmal supraventricular tachycardia and atrial fibrillation. CARPREG: Cardiac Disease in Pregnancy; ZAHARA: Zwangerschap bij Aangeboren Hartafwijking; mWHO: modified World Health Organization: ECG: electrocardiogram; FDA: Food and Drug Administration; CV: cardiovascular.
Management of supraventricular tachycardias and AF in pregnancy
Figure 2
Management of supraventricular tachycardias and atrial fibrillation in pregnancy. LMWH: low molecular weight heparin; SVT: supraventricular tachycardia; IV: intravenous; VKA: vitamin K antagonist; DAOC: direct oral anticoagulant
Management of ventricular tachycardia/fibrillation and SCA in pregnancy
Figure 3
Management of ventricular tachycardia, ventricular fibrillation, and sudden cardiac arrest in pregnancy. CPR: cardiopulmonary resuscitation; ACLS: advanced cardiac life support; IV: intravenous; ROSC: return of spontaneous circulation
See this image and copyright information in PMC

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