New Diagnosis of Atrial Fibrillation in Pregnancy: Literature Review and Clinical Conundrums

Atrial fibrillation (AF) during pregnancy is associated with increased maternal risk. New-diagnosis AF in pregnancy presents several complex clinical dilemmas, including decisions regarding stroke prophylaxis, the risk of AF recurrence, and the need for long-term anticoagulation beyond pregnancy. Evidence to inform these decisions is sparse, and existing risk-stratification tools have not been validated in pregnant populations. In this case-based series, we present 2 illustrative cases of new-diagnosis AF during pregnancy that highlight real-world management challenges and evidence gaps. These cases underscore the need for individualized clinical decision-making and multidisciplinary care in this patient population and the importance of further research/data to guide optimal management of AF in pregnancy. We review available literature, discuss practical considerations for anticoagulation and follow-up, and further highlight future research directions.