Department of Obstetrics and Gynecology, McGill University, Montréal, QC.
Department of Obstetrics and Gynecology, McGill University, Montréal, QC.
J Obstet Gynaecol Can. 2020 Aug;42(8):1012-1015. doi: 10.1016/j.jogc.2019.09.010. Epub 2019 Dec 25.
The hemodynamic and physiological changes of pregnancy may predispose women to cardiac arrhythmias such as atrial fibrillation (AF). Nevertheless, new-onset AF in pregnancy remains rare, and treatment is challenging. Current recommendations are to treat pregnant women with AF as non-pregnant adults, by using pharmacological or synchronized electrical cardioversion, without mention of gestational age or possibility of delivery.
A 23-year-old nulliparous woman developed new-onset symptomatic AF at 36 weeks gestation, but presented to our hospital was delivered at 36 weeks gestation. Beta-blockers were administered for heart rate control. After 48 hours, the decision was made to proceed with delivery rather than cardioversion. The patient's arrhythmia resolved spontaneously postpartum without further treatment.
In pregnant patients near or at term, delivery should be considered in the management of new-onset AF after consultation with cardiology, anaesthesiology, and maternal-fetal medicine.
妊娠时的血流动力学和生理变化可能使女性易患心律失常，如心房颤动（AF）。然而，妊娠期间新发 AF 仍然很少见，治疗具有挑战性。目前的建议是，对患有 AF 的孕妇采用与非妊娠成人相同的治疗方法，即使用药物或同步电复律，而不考虑妊娠年龄或分娩的可能性。
一位 23 岁的初产妇在妊娠 36 周时出现新发有症状的 AF，但在妊娠 36 周时被送到我院。给予β受体阻滞剂以控制心率。48 小时后，决定进行分娩而不是电复律。患者的心律失常在产后自发缓解，无需进一步治疗。
对于接近或处于足月的妊娠患者，在与心脏病学、麻醉学和母胎医学咨询后，应考虑在管理新发 AF 时进行分娩。
