RT Journal Article
SR Electronic
T1 Supraventricular arrhythmia in pregnancy
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP heartjnl-2021-320451
DO 10.1136/heartjnl-2021-320451
A1 Karishma P Ramlakhan
A1 Robert M Kauling
A1 Nicole Schenkelaars
A1 Dolf Segers
A1 Sing-Chien Yap
A1 Martijn C Post
A1 Jérôme Cornette
A1 Jolien W Roos-Hesselink
YR 2022
UL http://heart.bmj.com/content/early/2022/01/26/heartjnl-2021-320451.abstract
AB The physiological changes during pregnancy predispose a woman for the development of new-onset or recurrent arrhythmia. Supraventricular arrhythmia is the most common form of arrhythmia during pregnancy and, although often benign in nature, can be concerning. We describe three complex cases of supraventricular arrhythmia during pregnancy and review the currently available literature on the subject. In pregnancies complicated by arrhythmia, a plan for follow-up and both maternal and fetal monitoring during pregnancy, delivery and post partum should be made in a multidisciplinary team. Diagnostic modalities should be used as in non-pregnant women if there is an indication. All antiarrhythmic drugs cross the placenta, but when necessary, medical treatment should be used with consideration to the fetus and the mother’s altered pharmacodynamics and kinetics. Electrical cardioversion is safe during pregnancy, and electrophysiological study and catheter ablation can be performed in selected patients, preferably with zero-fluoroscopy technique. Sometimes, delivering the fetus (if viable) is the best therapeutic option. In this review, we provide a framework for the workup and clinical management of supraventricular arrhythmias in pregnant women, including cardiac, obstetric and neonatal perspectives.