Refractory Paroxysmal Atrial Tachycardia (PAT) During Pregnancy*

Abstract

There is increased susceptibility to various arrythmias including PAT during pregnancyl which becomes maximal late in term and during labour. Besides drugs, synchronous d.c cardioversion appears to he a safe mode of therapy for PAT2.

Patient finally responded to a combination of Quinidine 200 mg. Six hourly and Propranolol 40 mg. eight hourly for several days, and was discharged in normal sinus rhythm with B.P. of 120/70 mm Hg. During her stay she was examined twice by an obstetrician who found the pregnancy undisturbed.

Discussion:
PAT is not infrequent during pregnancy3. 19 cases of PAT were collected by Jenson upo
1938 4.. 10 cases were observed by Szekelv and Snaith ovez a 10 years period5. In the absence of structural heart disease the arrythmia usually did not interfere with the course of normal preg nancy.

In conclusion, refractory PAT may be seen in patients during pregnancy with no organic heart disease. While d-c cardioversion and overdrive atrial pacing can be carried out safely, it may not be successful. Drug treatment may be the only effective means in these patients. Quinidine was used with no side effects in the normal maintenance doses.