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New Onset Atrial Fibrillation During Cesarean Section
Abstract Number: 220
Abstract Type: Case Report/Case Series
Dysrrhythmias are infrequent during pregnancy in parturients free of cardiac disease. Most commonly sustained arrhythmias during pregnancy include accessory pathway mediated reentrant supraventricular tachycardias ( SVT) and AV nodal reentrant tachycardias (1, 2) . The new onset of atrial fibrillation in an otherwise healthy parturient is a rare occurrence with only two previous reports noted in the literature. (3,4) We present the case of new onset atrial fibrillation with a rapid ventricular response during cesarean section under spinal anesthesia in a patient free of known cardiac disease.
Physiologic changes associated with routine pregnancy including blood volume expansion, altered autonomic tone, and increased cardiac output can present a perfect storm favorable to dysrhythmia development (5). We expand on the current treatment guidelines for acute episodes of atrial fibrillation (AF) in pregnancy and also discuss the causes and potential complications of AF in parturients and it's associated morbidity.
1. Wilbur SL, Marchlinski FE: Adenosine as an antiarrhythmic agent. Am J Cardiol 1997, 79:30.
2. Widerhorn J, Widerhorn AL, Rahimtoola SH, et al.:WPW syndrome during pregnancy: increased incidence of supraventricular arrhythmias. Am Heart J 1992, 123:796.
3. Gowda RM, Punukollu G, Khan IA, et al. Lone atrial fibrillation during pregnancy. Int J Cardiol 2003;88:123– 4.
4. Krzysztof M. Kuczkowski, Letter to the Editor New onset transient lone atrial fibrillation in a healthy parturient: de ́ja` vu, International Journal of Cardiology 97 (2004) 339
5. Cacciotti L, Camastra GS, Ansalone G., Atrial fibrillation in a pregnant woman with a normal heart.
Intern Emerg Med. 2010 Feb;5(1):87-8.