Alberca Vela T, Palma Amaro J, García-Cosío Mir F
Servicio de Cardiología, Hospital Universitario de Getafe, Madrid.
Rev Esp Cardiol. 1997 Nov;50(11):749-59. doi: 10.1016/s0300-8932(97)74676-1.
Although arrhythmias are one of the most frequent consultations during pregnancy, fortunately the majority are benign. Usually, they are well tolerated assuming they occur in patients with structurally normal hearts. However, pregnancy adds a new aspect to the so called "arrhythmia tolerance", because arrhythmia and therapy may jeopardize the fetus. For acute treatment of narrow and wide tachycardias, with few exceptions, antiarrhythmic medications appear to be safe. In addition to the relative security of drugs such as adenosine, digoxin, propranolol, procainamide and flecainide, we could use direct current countershock with no evidence of significant complications. Because no drug is absolutely safe, chronic pharmacologic therapy is best avoided during pregnancy. Finally, radiofrequency ablation could be recommended as an alternative in women with previous tachycardias who would like to become pregnant.