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妊娠期女性因血容量增加、激素水平波动及心脏负荷加重等生理变化，心律失常的发生风险显著升高。其管理策略需在保障母体安全的同时，兼顾对胎儿的潜在影响。药物治疗应优先选择妊娠期安全性较高的药物，如β受体阻滞剂等；当药物疗效不佳时，可根据具体情况考虑同步直流电复律或导管消融。本文节选了《2023心脏节律协会妊娠期心率失常管理专家共识声明》中关于妊娠期常见心律失常的管理要点进行解读。其中，急性室上性心动过速应首选迷走神经刺激或腺苷，难治性病例可选用美托洛尔。心房颤动/心房扑动需抗凝并控制心室率，抗凝治疗需严格控制华法林的使用，且妊娠期禁用直接口服抗凝药。心率控制首选β受体阻滞剂。室性心律失常若存在植入式心脏复律除颤器(ICD)使用指征时建议在妊娠前植入ICD。针对特发性室性心动过速(VT),指南推荐使用β受体阻滞剂和腺苷治疗流出道型VT,使用维拉帕米治疗束支折返型VT。心动过缓/传导阻滞通常无需干预，伴有严重症状的患者需临时起搏。在妊娠期心律失常治疗过程中，临床决策应个体化、多学科合作以优化母婴结局。
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基本信息:
DOI：10.13333/j.cnki.cjcpe.2025.03.002
中图分类号:R714.252
引用信息:
[1]程锦潇,杨靖,王晞.《2023心脏节律协会妊娠期心律失常管理专家共识声明》要点解读[J].中国心脏起搏与心电生理杂志,2025,39(03):181-184.DOI:10.13333/j.cnki.cjcpe.2025.03.002.
基金信息: