Anaesthetic considerations in pregnant patients with cardiac arrhythmia

By reading this article, you should be able to: •Describe the maternal cardiovascular changes in pregnancy that predispose pregnant patients to arrhythmias. •Delineate the maternal and fetal morbidity associated with cardiac arrhythmias in pregnancy. •List the investigations that should be undertaken to diagnose cardiac arrhythmias in pregnancy. •Discuss the pharmacological and non-pharmacological strategies for managing arrhythmias. •Adopt a multidisciplinary approach to managing pregnant patients with arrhythmias. Kailash Bhatia FRCA EDRA DNB is a consultant anaesthetist at Saint Mary's Hospital, Manchester, where he is the lead obstetric anaesthetist for patients with heart disease in pregnancy. His interests include obstetric and regional anaesthesia and he is a council member of the UK Maternal Cardiology Society. Rohan D'Souza MD PhD FRCOG is a maternal–fetal medicine physician and associate professor of obstetrics and gynaecology with an interest in medical disorders in pregnancy and incorporating patient preferences into obstetric decision-making. Isabelle Malhamé MD MSc FRCPC is an obstetric medicine physician and researcher at the McGill University Health Centre. Her research interests include prediction and prevention of severe maternal morbidity, with a special interest for cardiovascular disease. Sara Thorne MD FRCP is a cardiologist and associate professor with an interest in obstetric cardiology and adult congenital heart disease at University Health Network, Mount Sinai Hospital and University of Toronto.