The United States reported the highest maternal mortality ratio in 2018. Arrhythmia incidence during pregnancy has been increasing. | |||||
| • | Pregnancy is associated with increased arrhythmia burden, and patients with a history of arrhythmias are at significant recurrence risk. | ||||
| • | Management of tachyarrhythmias depends on the presence of underlying structural heart disease and includes adenosine, β-blockers, and specific antiarrhythmic drugs with safety data during pregnancy. As a last resort, catheter ablation with minimal fluoroscopy can be used. | ||||
| • | Because of rising maternal mortality in the United States, which is partly driven by increasing maternal age and comorbidities, a multidisciplinary and/or integrative approach from prepregnancy to postpartum is needed.  | ||||
Frequency of Arrhythmias in Pregnancy and Associated Mortality and Complications Between 2000 and 2012
(A) Frequency of any arrhythmia per 100,000 pregnancy-related hospitalizations, stratified by age. (B) Frequency of arrhythmias per 100,000 pregnancy-related hospitalizations by arrhythmia type. (C) All-cause mortality for the entire study period. (D) Maternal and/or fetal complications by arrhythmia (including preterm labor, ante- or postpartum hemorrhage, preeclampsia, eclampsia, gestational hypertension, transfusion, postpartum infection, and fluid and electrolyte imbalance).
Safety Profiles of Commonly Used Medications for the Treatment of Arrhythmias in Pregnancy
Background colors refer to safety profiles of medications based on data and experience in pregnancy. Medications that can be safely used in lactation are also indicated separately by an icon.
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