Background: Pregnancy is associated with an increased frequency of arrhythmias in women with Wolff-Parkinson-White syndrome. We describe the use of intravenous (IV) adenosine for the acute termination of a narrow complex tachycardia in a pregnant patient with this syndrome.
Case: A 26-year-old woman with known Wolff-Parkinson-White syndrome presented with dizziness, palpitations, and a narrow complex supraventricular tachycardia. We used IV adenosine to convert the arrhythmia to a normal sinus rhythm. During labor, the patient again developed a narrow complex supraventricular tachycardia, and fetal monitoring revealed recurrent deep variable decelerations. Intravenous adenosine resulted in conversion to sinus rhythm and restoration of the fetal heart rate to normal. Cesarean delivery produced a healthy male infant.
Conclusions: Adenosine is effective in rapidly terminating maternal narrow complex tachyarrhythmias before and during delivery in women with Wolff-Parkinson-White syndrome. It can also treat fetal bradycardia resulting from the maternal arrhythmia.