Antiarrhythmic drug therapy in pregnancy and lactation

Am J Cardiol. 1998 Aug 20;82(4A):58I-62I. doi: 10.1016/s0002-9149(98)00473-1.


Antiarrhythmic agents commonly used in clinical practice are reviewed with respect to their potential for teratogenic or other adverse fetal effects. Although most experience with antiarrhythmic drug therapy during pregnancy has accrued with digoxin, quinidine, and propranolol, other antiarrhythmic agents may also be used in the pregnant patient if indicated. The choice of antiarrhythmic drug depends on the specific arrhythmia being treated, the cardiac condition of the patient or fetus, and the known or anticipated actions of the antiarrhythmic drug being considered. The management of specific arrhythmias encountered in pregnant women are also discussed. For benign arrhythmias, a conservative approach starting first with preventive measures is appropriate. For more severe or symptomatic arrhythmias, pharmacologic therapy should be instituted using drugs with proven safety to the fetus, if possible. Electrical cardioversion of the patient may be performed with relative safety in more emergent situations.

Publication types

  • Review

MeSH terms

  • Anti-Arrhythmia Agents / adverse effects
  • Anti-Arrhythmia Agents / therapeutic use*
  • Arrhythmias, Cardiac / drug therapy*
  • Female
  • Fetal Diseases
  • Humans
  • Infant, Newborn
  • Lactation / drug effects*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / drug therapy*
  • Tachycardia, Supraventricular / embryology


  • Anti-Arrhythmia Agents