Arrhythmias in Pregnancy.

Area of Science:

• Cardiology
• Maternal-Fetal Medicine
• Electrophysiology

Background:

• Maternal mortality and arrhythmia incidence, including atrial fibrillation, are rising in the US.
• Pregnancy elevates arrhythmia risk, particularly for those with pre-existing conditions.

Purpose of the Study:

• To review current management strategies for tachyarrhythmias and bradyarrhythmias during pregnancy.
• To discuss the treatment of cardiac arrest and fetal arrhythmias.
• To highlight the need for integrated care in managing arrhythmias in pregnant individuals.

Main Methods:

• Literature review of studies on pregnancy and arrhythmias.
• Analysis of treatment options for maternal and fetal arrhythmias.
• Discussion of procedural interventions and device implantation during pregnancy.

Main Results:

• Beta-blockers (propranolol, metoprolol) and antiarrhythmics (flecainide, sotalol) are safe for treating tachyarrhythmias in pregnant patients without structural heart disease.
• Catheter ablation and device implantation are feasible with minimal fluoroscopy and appropriate guidance.
• Fetal arrhythmias also have specific management considerations.

Conclusions:

• A multidisciplinary approach is crucial for managing arrhythmias throughout pregnancy and postpartum.
• Rising maternal age and comorbidities necessitate proactive and integrated arrhythmia care.
• Timely and appropriate management can mitigate risks associated with arrhythmias in pregnancy.