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Antiarrhythmic Safety in Pregnancy — EECC MCQ

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ModerateArrhythmia & ElectrophysiologyAntiarrhythmic Safety in PregnancyEECC

A 45-year-old woman with paroxysmal AF and no structural heart disease asks about the safety of flecainide during pregnancy. She is planning to conceive. What is the recommendation?

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Correct answer: DFlecainide may be used after specialist risk–benefit assessment; beta-blockers generally have more pregnancy safety experience

Pregnancy does not make every antiarrhythmic drug absolutely contraindicated. Flecainide has specialist uses for selected maternal and fetal tachyarrhythmias, but treatment should follow an individual maternal–fetal risk assessment; beta-blockers such as metoprolol have broader pregnancy experience. Amiodarone is generally reserved for exceptional, life-threatening circumstances.

Reference: NICE cardiovascular conditions guidance: https://www.nice.org.uk/guidance/conditions-and-diseases/cardiovascular-conditions