How does Atrial fibrillation affect pregnancy & how to monitor it?
Atrial fibrillation is the most common type of arrhythmia. In layman’s terms, Atrial fibrillation is a heart rhythm disorder that usually causes an arrhythmia or irregular heartbeat. The expansion of the plasma volume and decreased systemic vascular resistance to the increment of the cardiac output and the augmented sinus heart rate. For this reason, there is usually an increase in the incidence of Palpitations and cardiac arrhythmias. In addition to these various changes that happen to a woman’s body during the pregnancy period, those who have AFib must be very cautious of their heart rate to ensure they have an uneventful pregnancy period.
Atrial fibrillation during pregnancy is becoming more common with a high prevalence of rheumatic valvular heart diseases. Management of AF requires the use of antiarrhythmic and anticoagulant drugs which may affect foetal wellbeing. Pregnant women with AF need to be assessed by a cardiologist throughout pregnancy with a Cardiac telemetry monitor before & after the delivery for the proper choice of drugs and for clinical risk assessment.
What happens to your Heart during pregnancy?
During pregnancy, a woman’s blood volume increases by up to 50 percent, and her heart has to work much harder to pump that extra blood throughout the body. As a result, an increase in heart rate of up to 25 percent isn’t unusual during pregnancy, even among healthy women.
This is why even those healthy pregnant women tend to experience regular heart palpitations, skipped heartbeats, and flutters in their chests. This means that if you are already suffering from AFib then your burden of AF will automatically increase during your pregnancy.
Risks of Atrial fibrillation During Pregnancy
The management of AF during pregnancy has important implications for both maternal and foetal outcomes. AF management comprises therapies with prognostic impact anticoagulation and therapies predominantly providing symptomatic benefit. The choice between rhythm and rate control depends on the severity of the underlying valve disease, haemodynamic stability and tolerance.
But the use of anticoagulants during pregnancy is challenging due to the potential teratogenic effects and dosing complexities of the various agents, and the management of anticoagulation.
Onset Atrial fibrillation During Pregnancy
Although the chances of developing AFib during pregnancy are very low, there have been some few cases reported before. Generally, the condition is present in 8 percent of women during the onset of pregnancy. On the contrary, it only occurs in 25 percent of already pregnant women. Some of the factors that often contribute to a pregnant woman developing AFib are their maternal age, undiagnosed heart diseases, and their race. For this reason, it is very important for your doctor to evaluate your body for the presence of any rheumatic vascular disease, congenital heart disease, alcohol use, and electrolyte imbalances.
Symptoms of Atrial fibrillation
- Fast heartbeat
- Trouble or pain with breathing
- Pain that extends to shoulder, jaw, arm or back
- Sudden weakness or numbness on your face, arm or leg
- Fatigue & fainting
Risks of Afib Medications while carrying
In general, most medications tend to carry a lot of risks during pregnancy. Some of these risks include miscarriages, a higher rate of birth defects, and even premature labor. On the other hand, the attacks from your AFib can also be very dangerous to the point of slowing down the flow of blood to your growing baby. For this reason, you and your doctor will have to first weigh all the risks and benefits that are associated with the different treatments in your specific case. The results will be you switching some medications or even stopping taking the medications for AFib completely.
Atrial fibrillation During and After Giving Birth
During your labor period, your doctor will start tracking how your heart is performing. This will be done using ECG which is an in-hospital test that measures your heart’s electrical activity. This will be to ensure that the stress of giving birth does not result in a heart rhythm problem or cardiac arrhythmia.
After you have safely delivered your baby, your doctor will now allow you to start taking the blood-thinning medicines again. In case you are planning to breastfeed your baby, your doctor may adjust your medication.
How to monitor Atrial fibrillation?
Your doctor may recommend for you an ECG monitoring service to measure the electrical activity of your heart. He or she may also recommend a Cardiac event monitor which is a take-home EKG that you will wear every day for a period of up to 7-days. Both of these tests are very effective and are the standard tests for diagnosing atrial fibrillation. The portable ECG device is however much effective since it will provide your doctor with 24-hours remote cardiac monitoring. This ensures much-prolonged surveillance of your heart rhythms.
On the other hand, if you are pregnant and already have AFib, you should watch out for various signs of blood clots. The signs include chest pain, a faster heartbeat, lightheadedness, and sudden trouble seeing or speaking. Additionally, you should immediately call your doctor if you see any signs of a new arrhythmia or a worsening one the signs include rapid heartbeat, heart palpitations, and pounding or fluttering in your chest.
Sathya Kumar is the Founder & CEO of Cardiac Rhythm .Cardiac Rhythm’s biosensor is an unobtrusive, easy to use the device for the patient’s long-term Holter monitoring, cardiac ECG monitoring and real-time mobile cardiac telemetry monitoring. The innovative, portable biosensor remotely monitors the health of patients and provides physicians with deeper clinical-grade data insights.