Features of treatment of arrhythmias during pregnancy

S.S. Boev, N.Ya. Dotsenko, I.A. Shekhunova, L.V. Gerasimenko

Abstract


Prevalence of arrhythmias during pregnancy is increased both in women with the structural pathology of the heart, and in patients without a history of cardiovascular pathology. Physiological changes during pregnancy can predispose to the occurrence of arrhythmias, including atrial fibrillation, and contribute to an increase in morbidity and mortality from complications. According to the literature, in organic heart disease, atrial fibrillation is noted in a half of pregnant women, 52 % have ventricular arrhythmia, up to 44 % of pregnant women have supraventricular tachycardia, the risk of the latter is higher in pregnant women with Wolff-Parkinson-White syndrome. Mechanisms of arrhythmia development include hemodynamic, hormonal and functional changes occurring during pregnancy. However, the development of pregnancy is not accompanied by the emergence of specific electrophysiological changes in the structures of the myocardium and the conduction system of the heart. It is extremely important to distinguish those arrhythmias in pregnant women which violate hemodynamics, and also belong to malignant heart rhythm disorders and require specific pharmacotherapy, and in some cases also invasive methods of treatment. In the presented article, approaches to the treatment of arrhythmias during pregnancy are considered for both supporting antiarrhythmic therapy and for arrhythmia arrest, taking into account the classification of drugs according to the safety criteria for the fetus.

Keywords


cardiovascular pathology; heart rhythm disturbances; pregnancy; review

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DOI: https://doi.org/10.22141/2224-0586.6.85.2017.111603

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