{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:42:11Z","timestamp":1768570931798,"version":"3.49.0"},"posted":{"date-parts":[[2025,10,13]]},"group-title":"Cardiovascular Medicine","reference-count":15,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,10,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Atrial fibrillation\/flutter (AF\/AFL) and supraventricular tachycardia (SVT) are common arrhythmias in pregnancy. While known to contribute to adverse outcomes, large studies have not evaluated cardiac and perinatal outcomes in individuals with these arrhythmias.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To characterize the cardiac\/perinatal outcomes of patients with AF\/AFL and SVT in pregnancy.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a retrospective cohort study utilizing Epic Cosmos, a dataset from over 1,500 US hospitals. We identified pregnancies between October 25, 2021 and October 24, 2024 of patients with a diagnosis of AF\/AFL and SVT using simultaneous diagnoses codes for each arrhythmia and pregnancy. A control group of pregnancies without arrhythmias was also identified. Descriptive statistics were calculated, and comparisons were made with ANOVA or Chi-square tests, as appropriate.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    During the study period, there were 8,642 pregnant patients with AF\/AFL, 29,638 with SVT, and 5,372,171 healthy pregnant controls. Patients with these arrhythmias were older (AF\/AFL: 33\u00b16, SVT: 32\u00b16, control: 31\u00b16,\n                    <jats:italic>p<\/jats:italic>\n                    &lt;0.0001) with a higher BMI than the control group. Those with arrhythmias experienced higher rates of heart failure (AF\/AFL: 10.8%, SVT: 3.8%, control: 0.3%), thromboembolism, stroke, preterm birth, and cesarean delivery (all\n                    <jats:italic>p<\/jats:italic>\n                    &lt;0.0001). Patients with AF\/AFL had 23.9 times higher odds of stroke compared to the control group (95% CI 21.3-27.0).\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>While both AF\/AFL and SVT are associated with adverse cardiac and perinatal outcomes, AF\/AFL was associated with the highest risk of heart failure and stroke. Further research is needed to understand optimal perinatal AF\/AFL management, especially anticoagulation therapy given the high rate of maternal stroke.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.10.09.25337697","type":"posted-content","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T19:25:11Z","timestamp":1760383511000},"source":"Crossref","is-referenced-by-count":0,"title":["Cardiac and Perinatal Outcomes Among Pregnancies with Maternal Cardiac Arrhythmias"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1712-0514","authenticated-orcid":false,"given":"Gianna","family":"Wilkie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sruthi","family":"Takillapati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Majd Al Deen","family":"Alhuarrat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9420-7456","authenticated-orcid":false,"given":"Anna","family":"Whelan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7247-2272","authenticated-orcid":false,"given":"Lawrence","family":"Rosenthal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7919-2361","authenticated-orcid":false,"given":"Lara C.","family":"Kovell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025101512300931000_2025.10.09.25337697v1.1","doi-asserted-by":"crossref","unstructured":"Kotit S , Yacoub M. Cardiovascular adverse events in pregnancy: A global perspective. Global cardiology science & practice 2021; (1): e202105.","DOI":"10.21542\/gcsp.2021.5"},{"issue":"4","key":"2025101512300931000_2025.10.09.25337697v1.2","first-page":"e217548","article-title":"Cardiac Arrhythmias During Pregnancy","volume":"48","year":"2021","journal-title":"Texas Heart Institute Journal"},{"issue":"2","key":"2025101512300931000_2025.10.09.25337697v1.3","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.advms.2019.07.003","article-title":"Incidence of atrial fibrillation in pregnancy and clinical significance: A meta-analysis","volume":"64","year":"2019","journal-title":"Advances in medical sciences"},{"issue":"10","key":"2025101512300931000_2025.10.09.25337697v1.4","doi-asserted-by":"crossref","first-page":"e175","DOI":"10.1016\/j.hrthm.2023.05.017","article-title":"2023 HRS expert consensus statement on the management of arrhythmias during pregnancy","volume":"20","year":"2023","journal-title":"Heart rhythm"},{"issue":"4","key":"2025101512300931000_2025.10.09.25337697v1.5","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.3390\/jcm13041095","article-title":"Pregnancy Arrhythmias: Management in the Emergency Department and Critical Care","volume":"13","year":"2024","journal-title":"Journal of Clinical Medicine"},{"issue":"1","key":"2025101512300931000_2025.10.09.25337697v1.6","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jacep.2021.10.004","article-title":"Arrhythmias in Pregnancy","volume":"8","year":"2022","journal-title":"JACC Clinical electrophysiology"},{"issue":"2","key":"2025101512300931000_2025.10.09.25337697v1.7","doi-asserted-by":"crossref","first-page":"36","DOI":"10.14797\/mdcvj.1325","article-title":"An Overview of Arrhythmias in Pregnancy","volume":"20","year":"2024","journal-title":"Methodist Debakey Cardiovascular Journal"},{"key":"2025101512300931000_2025.10.09.25337697v1.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"2025101512300931000_2025.10.09.25337697v1.9","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.003182"},{"key":"2025101512300931000_2025.10.09.25337697v1.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2015.04.013"},{"issue":"2","key":"2025101512300931000_2025.10.09.25337697v1.11","first-page":"16","article-title":"Evaluation of CHA2DS2-VASc risk stratification tool in pregnant women with atrial fibrillation or atrial flutter","volume":"4","year":"2020","journal-title":"Clin Cardiol J"},{"key":"2025101512300931000_2025.10.09.25337697v1.12","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002706"},{"key":"2025101512300931000_2025.10.09.25337697v1.13","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.590257"},{"key":"2025101512300931000_2025.10.09.25337697v1.14","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.095240"},{"key":"2025101512300931000_2025.10.09.25337697v1.15","unstructured":"Yeo YH , San BJ , Mee XC , Tan MC , Tamirisa KP , Kaur S , Savasan ZA , Mehta N. Risk of Stillbirth and Preterm Birth in Cardiac Arrhythmias During Pregnancy. JACC Clin Electrophysiol 2025; S2405-500X(25)00175-6. Online ahead of print."}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2025.10.09.25337697","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:48:23Z","timestamp":1768510103000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2025.10.09.25337697"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,13]]},"references-count":15,"URL":"https:\/\/doi.org\/10.1101\/2025.10.09.25337697","relation":{},"subject":[],"published":{"date-parts":[[2025,10,13]]},"subtype":"preprint"}}