AF with Pregnancy

By: (Ayman Noureldin )
A- Rate control: beta-blockers, verapamil, diltiazem, and digoxin all carry a US Food and Drug Administration pregnancy safety category of C (benefits may outweigh risk), except for atenolol (categoryD: positive evidence of risk).
*** Their use should be at the lowest dose and for the shortest time required.
*** There are insufficient data to comment on verapamil or diltiazem, hence rate control using beta-blockers and/or digoxin is recommended.
B- Rhythm control
** Avoid Amiodarone
** Flecainide and sotalol can both be used.
** Electrical cardioversion if haemodynamically unstable
C- Anticoagulation
** Avoid NOACs