Coping With AFib and Pregnancy
Atrial fibrillation (AFib) is a heart rhythm disorder, causing an arrhythmia (an irregular heartbeat). AFib generally goes undiagnosed until something goes wrong.
Pregnant women living with AFib must pay special attention to their heart rates in order ensure a healthy pregnancy. Essentially, you need to make sure your heart rate stays at a normal level – which is 60 to 100 beats per minute.
Pregnant women are generally at a higher risk for blood clots of the heart during pregnancy. Pregnancy also increases the risk for blood clots in the legs.
If you have A-Fib, your doctor may prescribe blood thinning medications to reduce your chance of a clot. It is also possible for you to develop AFib during pregnancy.
Heart Changes During Pregnancy
When you are pregnant, your blood volume increases by up to 50 percent, which means your heart has to work much harder to pump blood throughout your body. As result, increases in heart rate – up to 25 percent – are not unusual, even in healthy women.
Blood volume and heart rate increases may trigger palpitations – when the heart beats too fast or irregularly. This is one symptom of an arrhythmia; other symptoms include lightheadedness, shortness of breath, and anxiety.
For healthy women or women with no previous history of arrhythmia, symptoms are generally harmless. But if you have had a previous abnormal heart rhythm or other heart conditions, an arrhythmia should be treated seriously, as it may be a sign of a bigger problem.
And if you have already been diagnosed with AFib, any arrhythmia symptoms, especially palpitations, need immediate medical attention.
New Onset AFib During Pregnancy
Developing AFib during pregnancy without a previous history of it is rare, but there have been some reported cases. AFib is present in 8 percent of women at the onset of pregnancy, but new onset only occurs in 2.5 percent of pregnant women according to researchers out of the Madre Giuseppina Vannini Hospital in Rome, Italy.
Certain factors, such as maternal age, race, and heart disease (sometimes undiagnosed due to lack of symptoms), increase your odds of developing AFib during pregnancy.
The Rome researchers also note that when healthy women develop AFib during pregnancy, it is important for their doctors to evaluate for congenital heart disease, rheumatic vascular disease, alcohol use, electrolyte imbalances, and hyperthyroidism. While these conditions or scenarios must be ruled out, AFib generally ends up being a lone condition.
One case, reported by the University of Texas in Austin, Texas, focused on a 40-year-old African American woman who was 23 weeks pregnant with twins and who developed new onset AFib.
The pregnant woman had an incomplete cervix, requiring stitches to keep the cervix closed to prevent it from opening early and causing preterm labor. She came to the hospital by ambulance and experienced persistent shortness of breath and palpitations for six hours.
She was treated for her symptoms in the ambulance, Upon arrival to the hospital, her shortness of breath had resolved but the palpitations continued. The patient denied alcohol and caffeine use, dehydration, sleep issues, illness, or other factors that could have contributed to her symptoms.
After various tests, she was officially diagnosed with new onset AFib and treated with medications to decrease her heart rate which eventually returned to a normal sinus rhythm. She was sent home with instructions to follow up with cardiology.
A similar case was reported by researchers from Dublin, Ireland, involving a 37-year-old woman who was 33-weeks pregnant with twins and with no previous history of AFib or other cardiac issues.
She came to the emergency room complaining of sudden onset palpitations. She was being treated for a urinary tract infection but was otherwise healthy.
The Irish patient was treated with beta blockers and when these did not help, she underwent cardioversion, an electric procedure using low-dose anesthesia, involving an electric shock outside the chest wall. Sinus rhythm was obtained and the patient showed no further symptoms for the rest of her pregnancy.