Pre-existing A-Fib, SVT and Pregnancy

[LuluLloyder]

Hi... I am a 37 yr old female diagnosed about four years ago with Atrial Fibrillation, Sub Ventricular Tachycardia and Mitral Valve Prolapse.  I get intermittent runs of Afib or SVT lasting anywhere from a few minutes to a few hours.  Digoxin treatment greatly reduced the number of episodes I have, but haven't eliminated them entirely. Being recently married, I wanted to start a family. After talking to my cardiologist and my husband, we decided while trying to get pregnant that I should get off of my medication, Digoxin, and aspirin therapy because it isn't safe for the fetus/baby. I have been having anxiety being off the Digoxin and not having any control over my arrhythmias.  I found out a few weeks ago that I'm pregnant! (7wks)  While I'm very excited, I'm nervous about my heart and the effects of having an arrhythmia will have on my unborn child. I will be seeing a perinatologist because I am considered a "high risk" pregnancy. The scary thing to me is that any doctor I have seen or talked to has not treated a woman my age with this disorder, let alone one that wants to have kids. There seems to be very little information out there about women with this as pre existing and going through pregnancy and delivery. I have a lot of questions about the effects of the disorder and medication on the baby as well as possible complications during delivery. For instance, would I automatically need to have a c-section to avoid extra pressure on my heart? No one seems to have information. If anyone out there has gone through pregnancy and delivery with pre-existing AFib and or SVT, I would love to hear what you have learned or what you know about it. I feel helpless like I'm not armed with enough information to handle my pregnancy safely. Thanks very much! I appreciate any input!

[ireneo]

Ablation for a-fib can be more complex so I understand why the EP wasn't anxious to do it if you can do rate or rhythm control by meds. I know one person on the board that is in a-fib for weeks at a time but because his rate (slower heart beat overall)  is controlled, he tolerates it well. It's certainly a case by case affair.

[LuluLloyder]

hi there..thank you for your feedback. It's great to hear your pregnancies went smoothly. I went to an electrophysiologist at one point to talk about ablation but they said they wouldn't touch it bc the electrical impulses were coming from all over the place and not in a regular pattern. I would have much rather had it fixed with surgery than continuing to take prescriptions the rest of my life and have anxiety about oncoming attacks...but what can you do. I have an appointment with my perinatologist tomorrow and I'm hoping he has some experience with this. It will make me feel much more comfortable with the whole situation. Thanks for your kind thoughts and prayers and good luck to you as well.

[ireneo]

My situation wasn't exactly like yours but this is what I had going on. Before anyone mentioned ablations to me, I was told I had PSVT (back in 1977). I had atrial tachy every day, sometimes multiple times a day with a HR of almost 200, lasting from 5 minutes to 45 minutes at a time. I was not given medicine, just told to use the Valsalva Maneuver (take a breath, hold it and bear down to hopefully stop the tachy).

I went on to have 3 children, natural childbirth each time. They did watch my heart carefully during the births but I had no problems.

Fast forward to 2000, I'm told I can have an ablation to fix my PSVT. Went in and they found PVC's, PAC's, PSVT and atrial flutter (a close cousin to a-fib). Huh. I've had 3 ablations now, the a-flutter is gone but the rest remain. I had abdominal surgery recently and they had to monitor my heart again. Everything worked out fine.

I can't predict how your heart will behave with a-fib but do express your concerns with your doctors. I wonder if you can start the medication (anti-arrhythmic) again near the end of term, after the baby is well developed and you're close to delivery time? Just a thought.  Congratulations on the new family member. I do hope and pray everything goes smoothly and both you and baby have a wonderful life together. Children are life changing in a good way.