Yaksh Ameeta, van der Does Lisette Jme, Lanters Eva Ah, de Groot Natasja Ms
Erasmus Medical Center, Rotterdam, The Netherlands.
Arrhythm Electrophysiol Rev. 2016 May;5(1):41-4. doi: 10.15420/AER.2016.1.2.
Tachyarrhythmias are the most frequently observed cardiac complications during pregnancy. The majority of these maternal and foetal arrhythmias are supraventricular tachyarrhythmias; ventricular tachyarrhythmias are rare. The use of anti-arrhythmic drugs (AADs) during pregnancy is challenging due to potential foetal teratogenic effects. Maintaining stable and effective therapeutic maternal drug levels is difficult due to haemodynamic and metabolic alterations. Pharmacological treatment of tachyarrhythmias is indicated in case of maternal haemodynamic instability or hydrops fetalis. Evidenc e regarding the efficacy and safety of AAD therapy during pregnancy is scarce and the choice of AAD should be based on individual risk assessments for both mother and foetus. This review outlines the current knowledge on the development of tachyarrhythmias during pregnancy, the indications for and considerations of pharmacological treatment and its potential side-effects.
快速性心律失常是孕期最常见的心脏并发症。这些母体和胎儿心律失常大多为室上性快速性心律失常；室性快速性心律失常较为罕见。由于潜在的胎儿致畸作用，孕期使用抗心律失常药物（AADs）具有挑战性。由于血流动力学和代谢改变，维持稳定有效的母体治疗药物水平很困难。母体血流动力学不稳定或胎儿水肿时，需进行快速性心律失常的药物治疗。关于孕期AAD治疗的有效性和安全性的证据很少，AAD的选择应基于对母亲和胎儿的个体风险评估。本综述概述了孕期快速性心律失常发生发展的现有知识、药物治疗的适应证和注意事项及其潜在副作用。
