Management of Arrhythmias During Pregnancy in Africa

Cardiac arrhythmias represent a significant clinical concern that have been always addressed. Moreover, Pregnancy introduces profound hormonal, autonomic, and hemodynamic changes that add more risk to cardiac patients and increase arrhythmia susceptibility. In our continent, Africa, there is an added risk because of the high prevalence of rheumatic heart disease, peripartum cardiomyopathy, and limited access to healthcare, contributing to adverse maternal and fetal outcomes. This article addresses the epidemics, mechanisms, and management of arrhythmias during pregnancy in African settings, highlighting high-yield real-life cases. We focus on guideline-based management strategies, emphasizing fetal safety, and discuss unique regional challenges, including limited access to drugs and restricted electrophysiology services. Data from a high-volume tertiary center in Egypt demonstrate that the key factors in such settings are multi-team cardio-obstetric care, timely intervention, and a balanced use of advanced electrophysiological techniques, which can achieve the best maternal and fetal outcomes despite constraints.