Effectiveness and Safety of Management Strategies for Cardiac Arrhythmias in Pregnancy: A Prospective Observational Study

Background:Cardiac arrhythmias during pregnancy pose significant risks to both maternal and fetal health, necessitating careful diagnostic and therapeutic strategies. Objective:To prospectively evaluate the management strategies and clinical outcomes of cardiac arrhythmias in pregnant women, focusing on the safety, effectiveness, and maternal-fetal implications of both pharmacologic and non-pharmacologic interventions. Methodology:A prospective observational study was conducted at the Department of Cardiology, Punjab Institute of Cardiology, Lahore, from July 2023 to June 2024. A total of 228 pregnant women diagnosed with cardiac arrhythmias were enrolled based on predefined inclusion criteria. Data were collected on demographics, arrhythmia type, diagnostic findings, management approaches, and maternal and fetal outcomes. Statistical analysis included Chi-square and t-tests with p < 0.05 considered significant. Results:Among the 228 participants, the most common arrhythmia was supraventricular tachycardia (SVT) (39.04%), followed by premature atrial contractions (18.42%) and premature ventricular contractions (15.35%). Pharmacologic management was used in 165 patients (72.37%), with beta-blockers being the most common (44.74%). Non-pharmacologic methods were used in 63 women (27.63%), including vagal maneuvers (17.98%) and electrical cardioversion (5.70%). Complete arrhythmia control was achieved in 174 women (76.32%), while 42 (18.42%) had moderate control, and 12 (5.26%) had recurrent episodes. Maternal complications included syncope (7.02%) and heart failure (3.95%). Fetal outcomes showed normal birth weight in 183 neonates (80.26%) and term delivery in 169 cases (74.12%). Two fetal deaths (0.88%) were reported. Conclusion:Arrhythmias in pregnancy can be effectively managed with a tailored, multidisciplinary approach, resulting in favorable maternal and fetal outcomes.