Treatment of arrhythmias during pregnancy
Abstract
The treatment of arrhythmias during pregnancy is complicated by concerns for fetal well-being. Although no drug is absolutely safe, most are well tolerated. Nonpharmacologic therapy includes vagal maneuvers and esophageal pacing. Temporary and permanent pacing have been used safely during pregnancy, as has direct current cardioversion. Cardiopulmonary resuscitation is complicated by concerns for the fetus, which may be viable at 25 weeks. Diagnosis of the cause of tachyarrhythmias may be enhanced by roving chest leads or esophageal recording. Both supraventricular and ventricular tachycardias may become manifest during pregnancy, and conservative management is desirable if the symptoms are mild. Supraventricular tachycardias respond acutely to adenosine. Ventricular arrhythmias during pregnancy often occur in the absence of structural heart disease and are responsive to drug therapy. The safe use of an implantable cardioverter-defibrillator has been described.
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None of the rate control agents are teratogenic, but they readily cross the placenta.
“None of the agents are teratogenic, but they readily cross the placenta.914”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [914]
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- Authors
- Page, R. L.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Page, Richard L.
- ORCID
- Page, Richard L.
- Venue
- American Heart Journal
- Publisher
- Elsevier BV
- Published
- 1995-10
- Volume
- 130
- Issue
- 4
- Pages
- 871-876
- ISSN
- 0002-8703 (ISSN-L)
- OpenAlex
- W2138257084
- Cited by
- 195
- References
- 50
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 8 · 2023: 6 · 2022: 6 · 2021: 6 · 2020: 11 · 2019: 6 · 2018: 2 · 2017: 4 · 2016: 8 · 2015: 8 · 2014: 4 · 2013: 4 · 2012: 8
- FWCI
- 1.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Issues in Pregnancy
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- cardiac arrhythmias in pregnancy, fetal safety, vagal maneuvers, esophageal pacing, temporary pacing, permanent cardiac pacing, electrical cardioversion, cardiopulmonary resuscitation, supraventricular tachycardia, ventricular tachycardia, adenosine, implantable cardioverter-defibrillator, antiarrhythmic drugs
- MeSH terms
- Anti-Arrhythmia Agents, Arrhythmias, Cardiac, Female, Humans, Pregnancy, Pregnancy Complications, Cardiovascular, Tachycardia, Supraventricular, Tachycardia, Ventricular
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