Antiarrhythmic Drug Use in Pregnancy: Considerations and Safety Profiles

Author:

Mariani Marco Valerio1ORCID,Pierucci Nicola12ORCID,La Fazia Vincenzo Mirco2ORCID,Cipollone Pietro1,Micillo Marco3ORCID,D’Amato Andrea1,Fanisio Francesca4ORCID,Ammirati Giuseppe5ORCID,Salagundla Nethuja6,Lavalle Carlo1,Perrone Marco Alfonso78ORCID

Affiliation:

1. Department of Clinical Internal Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy

2. Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, Austin, TX 78705, USA

3. Cardiology Department, S. Anna University Hospital, 44122 Ferrara, Italy

4. Division of Cardiology, Policlinico Casilino, 00169 Rome, Italy

5. Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy

6. Texas Health Arlington Memorial Hospital, Dallas, TX 76012, USA

7. Division of Cardiology and CardioLab, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy

8. Clinical Pathways and Epidemiology Unit, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy

Abstract

Pregnancy entails notable physiological alterations and hormonal fluctuations that affect the well-being of both the fetus and the mother. Cardiovascular events and arrhythmias are a major concern during pregnancy, especially in women with comorbidities or a history of arrhythmias. This paper provides an overview of the prevalence, therapies, and prognoses of different types of arrhythmias during pregnancy. The administration of antiarrhythmic drugs (AADs) during pregnancy demands careful consideration because of their possible effect on the mother and fetus. AADs can cross the placenta or be present in breast milk, potentially leading to adverse effects such as teratogenicity, growth restriction, or premature birth. The safety profiles of different classes of AADs are discussed. Individualized treatment approaches and close monitoring of pregnant women prescribed AADs are essential to ensure optimal maternal and fetal outcomes.

Publisher

MDPI AG

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