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Expert Review of Cardiovascular Therapy Volume 13, 2015 - Issue 12
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Reviews

Antiarrhythmic drugs in pregnancy

Jennifer M. WrightCardiovascular Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USACorrespondence[email protected]
,
Richard L. PageCardiovascular Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
&
Michael E. FieldCardiovascular Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Pages 1433-1444 | Published online: 29 Oct 2015

References

  • Papers of special note have been highlighted as:
  • * of interest
  • ** of considerable interest
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*A retrospective comparison of digoxin, flecainide and sotalol for the treatment of fetal tachycardia in >100 patients. No significant adverse fetal events were seen except for one episode of fetal bradycardia with maximal dose flecainide and sotalol used concomitantly

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*A retrospective chart review evaluating the efficacy and safety of flecainide for the treatment of fetal supraventricular tachycardia (SVT) after digoxin failure in 37 pregnancies. The study found increased conversion rates with addition of flecainide without any significant fetal adverse events with either drug exposure

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*A retrospective study reviewing 2459 patients exposed to β-blockers during pregnancy and found an association between β-blocker use and increased risk for small for gestational age newborns, preterm labor and perinatal mortality when compared to the unexposed population

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*Retrospectively evaluated pregnancy outcomes when β-blockers were used for the treatment of maternal heart disease. Despite the presence of maternal heart disease in all patients, β-blockers were associated with an increased risk for low birth weight, particularly if used for a longer duration, compared to the unexposed cohort

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*A retrospective evaluation of amiodarone therapy for fetal SVT treatment after digoxin failure in the setting of hydrops. SVT conversion rates were high with amiodarone though nearly one-third of exposed fetuses developed transient fetal hypothyroidism

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*A retrospective evaluation of sotalol therapy with or without digoxin for the treatment of fetal SVT. Notably, there were no significant adverse events in the 21 pregnancies reviewed

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