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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
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Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
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Related Experiment Video

Updated: Aug 3, 2025

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Direct current cardioversion in pregnancy: a multicentre study.

Matthew Cauldwell1, Dawn Adamson2, Kaliash Bhatia3

  • 1Department of Obstetrics, Maternal Medicine Service, St George's Hospital, Blackshaw Road, London, UK.

BJOG : an International Journal of Obstetrics and Gynaecology
|April 11, 2023
PubMed
Summary

Direct current cardioversion (DCCV) in pregnancy is a rare but necessary procedure. This study found no maternal deaths in 27 cases, with all 29 pregnancies resulting in live births, emphasizing its safety when indicated.

Keywords:
arrhythmiaatrial fibrillationatrial fluttercardioversionheart diseasematernalmorbiditytachycardia

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Area of Science:

  • Cardiology
  • Maternal-Fetal Medicine
  • Obstetrics

Background:

  • Direct current cardioversion (DCCV) during pregnancy is infrequently documented.
  • Concerns exist regarding withheld DCCV in pregnant patients, potentially leading to adverse maternal outcomes.

Purpose of the Study:

  • To evaluate maternal and fetal outcomes following direct current cardioversion (DCCV) in pregnant women.
  • To assess the safety and efficacy of DCCV in managing cardiac arrhythmias during gestation.

Main Methods:

  • Retrospective cohort study involving 27 pregnant women who underwent DCCV.
  • Data collected from 17 specialist maternity centres across the UK and Ireland.

Main Results:

  • No maternal deaths occurred among the 27 women undergoing 29 DCCVs.
  • All 29 pregnancies resulted in live births, with a median delivery gestation of 35 weeks.
  • Common arrhythmias included atrial fibrillation (44%) and atrial flutter (30%); fetal monitoring was inconsistently applied post-procedure.

Conclusions:

  • Direct current cardioversion (DCCV) in pregnancy is safe and effective when clinically indicated, with no reported maternal mortality in this cohort.
  • Post-DCCV, appropriate fetal monitoring based on gestational age is recommended.
  • Maternity units should establish multidisciplinary protocols to ensure pregnant women receive timely and equivalent care for cardiac conditions.