Arrhythmias in pregnancy

Associate Editor:

Although underlying reasons remain unclear, a significant increase of the incidence and severity of cardiac arrhythmias in pregnancy (particularly atrial and ventricular premature beats without an existing heart disease) have been reported in numerous articles, and these arrhythmias are usually benign.

It is necessary to check if a pregnant woman takes any over the counter drug which causes palpitation or premature beats (e.g., pseudoephedrine).

Anti-arrhythmic Drugs to Avoid During the Pregnancy:

 * Amiodarone :
 * Significant fetal abnormalities.
 * Neonatal hypothyroidism
 * Fetal goiter
 * Fetal growth retardation


 * Propranolol and atenolol :
 * Intrauterine growth restriction
 * Hypoglycemia in the newborn

Anti-arrhythmic Drugs to Avoid During Lactation:

 * Amiodarone :
 * Secreted in breast milk


 * Acebutolol :
 * It becomes concentrated in breast milk. Infants receive much larger doses.
 * Neonatal bradycardia
 * Neonatal hypoglycemia