Introduction
Due to advanced maternal age, cardiovascular risk factors, and the
successful management of congenital heart diseases, the prevalence of
cardiovascular conditions complicating pregnancy is rising. Arrhythmias
in pregnancy are rare but, when present, they increase mother and fetus
morbidity and mortality by 1.5-3 times.
The most frequent arrhythmias, apart from premature beats, are atrial
fibrillation (AF) and paroxysmal supraventricular tachycardia (PSVT).
While the first is observed in 27 cases every 100.000 pregnant women,
the second is observed in 22-24/100.000. Pregnancy can be either the
trigger for a first episode or a catalyzer for recurrences, especially
in older women and in those with congenital heart disease. However,
symptomatic exacerbations of PSVT are usually benign, and in most of the
times, they can be controlled with medication. Fortunately,
life-threatening ventricular tachycardia (VT) and ventricular
fibrillation are even rarer during pregnancy, also occurring especially
in patients with congenital heart disease.
The purpose of this review is to facilitate the approach to tachycardias
in pregnant women and to present a new algorithm considering the
efficacy and drug safety based on the current evidence.