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Published on: February 26, 2013
Atrial Fibrillation and Atrial Flutter in Pregnancy: Epidemiology, Pathophysiology, and Management
Jessie Y Li-Barton1, Virginia Y Watkins2, Sarah C Snow3
1Department of Obstetrics and Gynecology.
Obstetrical & Gynecological Survey
|June 4, 2026
Summary
Atrial fibrillation (AF) and atrial flutter (AFL) are increasingly common in pregnancy, posing risks to both mother and fetus. Effective management requires understanding pregnancy-specific challenges and employing multidisciplinary, individualized treatment strategies for optimal outcomes.
Area of Science:
- Cardiology
- Obstetrics
- Maternal-Fetal Medicine
Background:
- Atrial fibrillation (AF) and atrial flutter (AFL) are the most common sustained cardiac arrhythmias during pregnancy.
- The prevalence of AF/AFL in pregnant populations has been rising, necessitating specialized clinical approaches.
- Managing these arrhythmias in pregnancy requires balancing maternal and fetal well-being due to unique physiological changes.
Purpose of the Study:
- To synthesize current evidence and expert recommendations for evaluating and managing AF/AFL in pregnant individuals.
- To highlight epidemiological trends, risk factors, and pregnancy-specific considerations for AF/AFL.
- To outline evidence-based treatment strategies for AF/AFL during pregnancy.
Main Methods:
- Comprehensive literature review of AF/AFL in pregnancy.
- Inclusion of epidemiologic data, pathophysiologic mechanisms, and management guidelines.
- Focus on maternal-fetal safety of pharmacologic agents and nonpharmacologic interventions.
Main Results:
- Pregnancy with AF/AFL is linked to elevated maternal and fetal risks.
- Physiological adaptations during pregnancy heighten arrhythmia and thromboembolic risks.
- Essential components of care include antepartum/intrapartum planning, rhythm/rate control, anticoagulation, and emergency protocols.
Conclusions:
- Increasing AF/AFL prevalence in pregnancy demands enhanced clinician knowledge of specific management strategies.
- Optimizing maternal and fetal outcomes hinges on early detection and tailored therapies.
- Multidisciplinary collaboration is crucial for improving prognosis in pregnant patients with AF/AFL.
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