Arrhythmias in Pregnancy: A Comprehensive Review

Cardiac arrhythmias are increasingly recognized as contributors to maternal morbidity and mortality, particularly in women with preexisting cardiovascular disease. The hemodynamic, hormonal, and autonomic changes of pregnancy can unmask or exacerbate underlying arrhythmogenic conditions. This review summarizes current data on the classification, epidemiology, and management of arrhythmias during pregnancy. Antiarrhythmic therapy requires careful consideration of maternal benefit versus fetal risk, including concerns about teratogenicity and neonatal drug exposure. Management must be individualized and account for the altered pharmacokinetics of pregnancy. Despite growing awareness of this challenge, evidence remains limited, and prospective studies are needed to inform clinical guidelines. A multidisciplinary, evidence-based approach is essential to optimize outcomes for both mother and fetus.