Reproductive Issues in Adults with Congenital Heart Disease: Arrhythmias During Pregnancy: Importance, Diagnosis and Therapy

Even in healthy women, increased ectopic activity is commonly seen during pregnancy. Congenital heart defects - whether nonoperated or operated - are, in general, associated with an increased risk of arrhythmias to a greater or lesser extent. During pregnancy, congenital heart disease patients are at increased risk of presenting first time with a symptomatic arrhythmia or, if previously diagnosed, the risk of recurrence of their arrhythmia is increased. Antiarrhythmic therapy should in general be restricted to the presence of intolerable symptoms, hemodynamic compromise or threat to the fetus and to patients in whom the arrhythmia may be life-threatening. The risk/benefit ratio must be considered for both the mother and the fetus. Considerations include the stage of pregnancy as well as possible effects of therapy on labor, delivery, and lactation. Nearly all of the presently available antiarrhythmic drugs are classified as Category C drugs in pregnancy. Thus, we rely on observational reports. Safety data are discussed for various drugs, and recommendations for the treatment of various arrhythmias are presented in this review.

Key words:

Arrhythmias - Pregnancy - Congenital heart disease

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