July 13, 2026Heart Rhythm
2023 HRS expert consensus statement on the management of arrhythmias during pregnancy
Why the study?
Comprehensive point-of-care guidance was needed for electrophysiologists, cardiologists, and other healthcare professionals managing cardiac arrhythmias in pregnant patients and fetuses.
Key Points
- To provide expert recommendations for managing arrhythmias during pregnancy based on current evidence and clinical practice.
- Consensus developed by a panel of experts in cardiology and obstetrics
- Review of recent literature on arrhythmia management during pregnancy
- Formulation of guidelines focusing on maternal and fetal safety
- Recommendations include monitoring strategies and medication use for pregnant individuals with arrhythmias
- Emphasis on the importance of individualized treatment plans based on risk factors
- Guidelines highlight potential impacts on fetal outcomes due to maternal arrhythmias
PICO
P
Population
Cardiac arrhythmias during pregnancy
I
Intervention / Comparator
Management of arrhythmias
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
AJACC Journal Scan
“For individuals with cardiac conditions, including arrhythmias, lactation presents unique clinical considerations because antiarrhythmic medications must balance maternal cardiovascular stability against minimal infant drug exposure.”
“Managing arrhythmias in pregnant patients requires a multidisciplinary care team approach because both the mother and the fetus can be affected. 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 the reflect each patient's individual personal preferences.”
Implication
Supports safe arrhythmia management in pregnancy prioritizing maternal-fetal outcomes; extends literature synthesis into actionable expert consensus for clinicians.
Abstract
This international multidisciplinary expert consensus statement is intended to provide comprehensive guidance that can be referenced at the point of care to cardiac electrophysiologists, cardiologists, and other health care professionals, on the management of cardiac arrhythmias in pregnant patients and in fetuses. This document covers general concepts related to arrhythmias, including both brady- and tachyarrhythmias, in both the patient and the fetus during pregnancy. Recommendations are provided for optimal approaches to diagnosis and evaluation of arrhythmias; selection of invasive and noninvasive options for treatment of arrhythmias; and disease- and patient-specific considerations when risk stratifying, diagnosing, and treating arrhythmias in pregnant patients and fetuses. Gaps in knowledge and new directions for future research are also identified.
Discussion
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Cite This Study
Joglar et al. (2023) conducted a review in Cardiac arrhythmias during pregnancy. Management of arrhythmias was evaluated. This expert consensus statement provides comprehensive guidance on the diagnosis, evaluation, and management of cardiac arrhythmias in pregnant patients and fetuses.