{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:07:41Z","timestamp":1790690861772,"version":"4.1.0"},"reference-count":40,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JRSM Cardiovascular Disease"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Arrhythmias are common during pregnancy and, although most are benign, they are associated with increased rates of maternal and fetal morbidity and mortality. The most frequent arrhythmias during pregnancy are sinus tachycardia and premature atrial complexes or ventricular complexes, which are often benign and resolve post-partum. However, tachyarrhythmias such as supraventricular tachycardia, atrial fibrillation and ventricular tachycardia are also more prevalent in pregnancy and require careful management, as they are associated with adverse maternal and fetal outcomes. A systematic approach to diagnosis is essential to identify the women with benign conditions and those with serious pathology. This involves thorough history taking, including past medical and family history, physical examination, and consideration of additional investigations such as electrocardiograms. The key diagnostic test is often a heart rhythm recording at the time of symptoms. When an arrhythmia has been identified, management strategies must balance maternal health with fetal safety. Beta-blockers, the first-line pharmacological treatment for many symptomatic arrhythmias, are not teratogenic but are associated with fetal growth restriction. Adenosine, flecainide, calcium channel blockers, digoxin and sotalol can also be safely used. Electrical cardioversion is safe at all stages of pregnancy and should not be delayed in emergencies. Procedures, such as the implantation of cardiac devices or ablations, can also be performed during pregnancy. Arrhythmias during pregnancy require individualised and multidisciplinary management plans to ensure optimal outcomes for both mother and fetus. This narrative review discusses the diagnosis and management of arrhythmias in pregnancy, including diagnostic work-up, pharmacological therapy, cardiac devices and electrophysiological procedures.<\/jats:p>","DOI":"10.1177\/20480040251391929","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T14:49:11Z","timestamp":1764341351000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Arrhythmia in pregnancy: Approaches to diagnosis and management"],"prefix":"10.1177","volume":"14","author":[{"given":"Marina","family":"Roelas","sequence":"first","affiliation":[{"name":"King's College Hospital NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5361-5725","authenticated-orcid":false,"given":"John","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust"},{"name":"School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6514-844X","authenticated-orcid":false,"given":"Siara","family":"Teelucksingh","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust"},{"name":"South West London and Surrey Heartlands Maternal Medicine Network, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9095-5887","authenticated-orcid":false,"given":"Antonio","family":"de Marvao","sequence":"additional","affiliation":[{"name":"King's College Hospital NHS Foundation Trust"},{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust"},{"name":"Department of Women and Children's Health, King's College London, London, UK"},{"name":"British Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK"},{"name":"Medical Research Council Laboratory of Medical Sciences, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf193"},{"key":"e_1_3_2_3_2","unstructured":"Felker A Knight M. Saving lives improving mothers\u2019 care: lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2020-22. 2024."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001981"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15376"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000090"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003721"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.009029"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.04.017"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.098822"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2021.10.004"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvu013"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc4301.098253"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2023.05.017"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00047-7"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(81)90497-X"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-5273(02)00601-0"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.10.075"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-312624"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20326"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.02.003"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199103213241201"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.11.041"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001554"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2011.03177.x"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-0188-7"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.08.004"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2024.132234"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.0608"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(99)00031-X"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2024-0114"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab065"},{"key":"e_1_3_2_33_2","doi-asserted-by":"crossref","unstructured":"Mehta LS Warnes CA Bradley E et al. Cardiovascular considerations in caring for pregnant patients: A scientific statement from the American Heart Association. Circulation [Internet]. 2020;141. https:\/\/www.ahajournals.org\/doi\/10.1161\/CIR.0000000000000772","DOI":"10.1161\/CIR.0000000000000845"},{"key":"e_1_3_2_34_2","first-page":"323","article-title":"Radiation-free nonselective his pacing lead implantation in a pregnant patient with congenitally corrected transposition of the great arteries","volume":"7","author":"Whitaker J","year":"2021","unstructured":"Whitaker J, Kreidieh O, Singh M, et al. Radiation-free nonselective his pacing lead implantation in a pregnant patient with congenitally corrected transposition of the great arteries. Hear Case Rep 2021; 7: 323\u2013327.","journal-title":"Hear Case Rep"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur018"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.9.2808"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15728"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17777"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000273"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2014-204466"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2021.02.011"}],"container-title":["JRSM Cardiovascular Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20480040251391929","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20480040251391929","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20480040251391929","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T14:49:12Z","timestamp":1764341352000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20480040251391929"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":40,"alternative-id":["10.1177\/20480040251391929"],"URL":"https:\/\/doi.org\/10.1177\/20480040251391929","relation":{},"ISSN":["2048-0040","2048-0040"],"issn-type":[{"value":"2048-0040","type":"print"},{"value":"2048-0040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"article-number":"20480040251391929"}}