Arrhythmias in Pregnancy

The prevalence of arrhythmias in pregnant women are rising, particularly among women with a history of structural heart disease or prior arrhythmia. The physiological changes of pregnancy increase the risk of both benign and pathologic arrhythmias, with atrial fibrillation representing the most common pathologic arrhythmia. While bradyarrhythmias rarely require treatment during pregnancy, pharmacotherapy is frequently required for tachyarrhythmias. Electrophysiological procedures including cardioversions, ablations, and device placement are occasionally required during pregnancy and can be performed safely with proper precautions. This chapter will discuss the diagnosis and management of a broad array of cardiac arrhythmias that may be encountered in pregnant women.