TABLE 9

Recommendations for Treatment Strategies for SVT During Pregnancy

Treatment StrategyRecommendationClassificationLevel of Evidence
Acute conversion of PSVTVagal maneuverIC
AdenosineIC
DC cardioversionIC
Metoprolol, propranololIIaC
VerapamilIIbC
Prophylactic therapyDigoxinIC
MetoprololIB
PropranololIIaB
Sotalol,flecainideIIaC
Quinidine, propafenone,verapamilIIbC
ProcainamideIIbB
Catheter ablationIIbC
AtenololIIIB
AmiodaroneIIIC

The order in which treatment recommendations appear in this table within each class of recommendation does not necessarily reflect a preferred sequence of administration. Please refer to text for details. For pertinent drug dosing information please refer to the ACC/AHA/ESC Guidelines on the Management of Patients With Atrial Fibrillation.

AV indicates atrioventricular; DC, direct current; PSVT, paroxysmal supraventricular tachycardia.

  • Beta-blocking agents should not be taken in the first trimester, if possible.

  • Consider AV-nodal-blocking agents in conjunction with flecainide and propafenone for certain tachycardias (see Section V).

  • Atenolol is categorized in class C (drug classification for use during pregnancy) by legal authorities in some European countries.