A new expert consensus statement released by the Heart Rhythm Society (HRS) is focused on the management of cardiac arrhythmias during pregnancy. Endorsed by the ACC, the statement offers practical guidance for electrophysiologists, cardiologists and other health care professionals on the optimal management of arrhythmias in pregnant patients and in fetuses worldwide.

Specifically, the statement includes dedicated sections on:

• General concepts related to arrhythmias in both the patient and the fetus during pregnancy
• Optimal approaches to diagnosis and evaluation of arrhythmias during pregnancy
• Approaches for invasive and noninvasive treatments of arrhythmias in pregnant patients
• Disease- and patient-specific considerations when risk stratifying, diagnosing and treating arrhythmias in pregnant patients
• Management of fetal arrhythmias

Shared decision-making with patients and among a multidisciplinary care team is also highlighted throughout the statement. “Managing arrhythmias in pregnant patients requires a multidisciplinary care team approach because both the mother and the fetus can be affected,” said Statement Chair Jose A. Joglar, MD, FACC. “Throughout the pregnancy, delivery, and postnatal period it is vital that the patient and care team engage in shared decision-making discussions that consider the risks and benefits of treatment vs. no treatment and eflect each patient’s individual personal preferences.”

According to the Writing Committee, the statement was developed taking into consideration the health benefits, side effects and risks to both the pregnant patient and fetus, as well as current evidence and standards of care. However, Joglar and colleagues note that the availability of resources, technology and health care delivery logistics vary widely in different parts of the world. “Some procedures are better performed, and some disease states are better managed, in settings where there is specific expertise,” said Joglar.

The statement was released during HRS 2023 in New Orleans.

Clinical Topics: Arrhythmias and Clinical EP, Congenital Heart Disease and Pediatric Cardiology, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement

Keywords: Risk Assessment, Arrhythmias, Cardiac, Fetus, Drug-Related Side Effects and Adverse Reactions, Iatrogenic Disease, Cardiologists, Pregnancy

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