Management of AF in pregnancy

1-Rate vs. Rhythm control?

Answer: Rhythm control is preferred over rate control to avoid side effects of the drugs(Rhythm control is usually achieved by DC cardioversion).

2-Drugs used for rate control :

-Selective B1 blockers(metoprolol or bisoprolol) (class I)
-Calcium channel blockers(Verapamil)(class IIa)
-Digoxin (class IIa)

3-Drugs used for Rhythm control:

-Sotalol
-Propafenone or flecainide (for structually normal heart or pre-excitation)

NB:Amiodarone is contraindicated with pregnancy

4-Drugs used for anticoagulation:

Either therapeutic weight based LMWH or warfarin based on stage of pregnancy

NB:NOACs are contraindicated in pregnancy and lactation

I-First trimester:

LMWH or warfarin if dose less than 5mg

II-Second trimester until 36 weeks:

Warfarin

III-After 36 weeks to 36 hours before delivery:

LMWH

IV-36 hours before and After deliverly:

UFH infusion
(stop 6 hours before delivery)

(instead of the UFH strategy, you can stop LMWH 24 hours before delivery if low risk for thromboembolism)

5-The decision for giving anticoagulation is based on CHADS-VASc score

Reference: ESC guidelines for management of CVD with pregnancy 2018
#CQtips
By Dr Ahmed Mohsen

تجميع كل البوستات السابقه ⬆⬆❤

‏"وَآخِرُ دَعْوَاهُمْ أَنِ الْحَمْدُ لِلَّهِ رَبِّ الْعَالَمِينَ " ❤
وصلنا لنهاية شبتر الكارديو 🫀 بمجمل 120 بوست خلصنا فيهم المواضيع التالية :
Hypertension , Heart Failure , Stable Angina , STEMI ,Dyslipidemia , AF ...

شكرا جزيلا لكل حد ساعدني في تجميع المعلومات 💙

تجميع للشباتر Pdf ;
🌸Arrhythmia & AF :
https://drive.google.com/file/d/1Hxu1sNdwumRnFdNqAeDihsdgqAV7aEVu/view?usp=drivesdk

🌸 Stable Angina

https://drive.google.com/file/d/1vkxiOMQbalRV9eoozRCKJ90s8s1sT05R/view?usp=drivesdk

🌸STEMI

https://drive.google.com/file/d/1zAs2bBrrdUlEXyn1vKJkNUZvtJO8FhIS/view?usp=drivesdk

🌸Heart Failure

https://drive.google.com/file/d/1hyGxG3R22R4wQEV-5S1ottzZ9ndmdb-x/view?usp=drivesdk

🌸Hypertension

https://drive.google.com/file/d/1Ay5TiZa_QHtZJnA0In76Ab4VIM9gqWX_/view?usp=drivesdk

🌸Dyslipidemia

Pdf :
https://drive.google.com/file/d/16w3ZtifCAu-ARvpQwj0b5p7p9kzjTymJ/view?usp=drivesdk

الشباتر السابقة ؛

🌸GIT

https://drive.google.com/file/d/1eg0tR2jP6vvvtPypORwfRIzRS14f09TV/view?usp=drivesdk

🌸Sepsis ( محتاج ابديت لبعض التعديلات حسب اخر جايدلاين)

https://drive.google.com/file/d/1_Q6sICFUUG7CIGDgSA2zKdRAxpNYXzvm/view?usp=drivesdk

🌸Acute Kidney Injury

https://drive.google.com/file/d/1_MX-T0X6Q3WwuHe2_ldh-DLcNcakU8Yu/view?usp=drivesdk

🌸Chronic Kidney Injury

https://drive.google.com/file/d/1_FZ56MVb4hwF4dj7LP7otxhJ468dWeWz/view?usp=drivesdk


#لعلي_أفيدك ❤
ان شاء الله الفتره القادمه هنبدأ بال Hematology