Key result
Rate control and delivery successfully resolved atrial fibrillation with rapid ventricular response in a pregnant woman presenting with mirror syndrome.
Case Report (n=1)
No
New-onset atrial fibrillation in pregnancy can be a presenting symptom of mirror syndrome secondary to fetal hydrops, which resolves following delivery.
May support delivery timing for AF resolution in mirror syndrome; hypothesis-generating and requires prospective confirmation before practice change.
Mirror syndrome is the phenomenon of fetal hydrops causing maternal edema and weight gain. Here, we report a case of arrhythmia as the primary maternal symptom. A 36-year-old woman, G2P1001, at 34.5 weeks of gestation presented with new-onset fetal hydrops combined with maternal weight gain and edema. She developed atrial fibrillation with rapid ventricular response; cardiac workup was unremarkable. Rate control was achieved with diltiazem. She underwent delivery and reverted to normal sinus rhythm on post-operative day 1. Volume overload causes atrial wall stress and neurohormonal changes that may trigger atrial fibrillation. Optimization with rate control facilitated good maternal and fetal outcomes in this case.
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HogenEsch et al. (2022) conducted a case report in Mirror syndrome with atrial fibrillation (n=1). Rate control and delivery was evaluated on Resolution of atrial fibrillation. Rate control and delivery successfully resolved atrial fibrillation with rapid ventricular response in a pregnant woman presenting with mirror syndrome.
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