I'm 35 y.o. and am 5 months pregnant. I had a first-ever episode of SVT (reentrant pathway) a few weeks ago. (HR 200bpm for about 3 hours before cardioversion with IV Adenosine.) I was prescribed Atenolol (25mg/day), and also given Metoprolol tablets (25mg) to take if there is another episode. A few questions:
1) I'm very concerned about continuing on the Atenolol, since it's Category D and linked to slowed fetal growth, low birthweight and smaller placentas. I'd like to taper off (under my OB's supervision). If I go off the Atenolol and have another episode (and take Metoprolol to stop it), is that worse for the fetus than taking Atenolol daily? What is the risk to the fetus of another SVT episode?
2) My blood pressure is normally on the low side (around 101/63 average). Is this at all relevant, either to the importance/harm of taking the beta blocker or to the likelihood of having another SVT episode?
3) If I go off Atenolol, is there any reason that my prenatal care would otherwise be especially complicated by the SVT? (Assuming a cardiologist is available for consultation when necessary.)
4) If I stay on the Atenolol, isn't there a risk to the baby during labor/delivery? Are pregnant women usually told to taper off near their due date? Since I'm planning to breastfeed, I don't want to take Atenolol after the birth.
Sorry this was long. Thanks very much for your help.