Baumgartner H
Department of Cardiology, Vienna General Hospital, University of Vienna, Austria.
Thorac Cardiovasc Surg. 2001 Apr;49(2):94-7. doi: 10.1055/s-2001-11696.
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.
即使在健康女性中，孕期也常见异位活动增加。先天性心脏病——无论是否接受过手术——总体上或多或少都与心律失常风险增加相关。在孕期，先天性心脏病患者首次出现症状性心律失常的风险增加，或者如果之前已被诊断，其心律失常复发的风险也会增加。抗心律失常治疗一般应限于出现无法耐受的症状、血流动力学受损或对胎儿有威胁的情况，以及心律失常可能危及生命的患者。必须考虑对母亲和胎儿的风险/获益比。考虑因素包括妊娠阶段以及治疗对分娩、生产和哺乳可能产生的影响。目前几乎所有可用的抗心律失常药物在孕期都被归类为C类药物。因此，我们依赖观察性报告。本综述讨论了各种药物的安全性数据，并给出了治疗各种心律失常的建议。
