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.