Impact of Atrial Fibrillation Management on Postpartum Outcomes: A Retrospective Analysis

Document Type

Conference Proceeding

Publication Date

4-7-2026

Publication Title

Journal of the American College of Cardiology

Abstract

BACKGROUND The incidence of atrial fibrillation (AF) in pregnancy is rising, but the impact of AF management strategies on postpartum outcomes remains poorly understood. METHODS We reviewed electronic medical records to identify pregnant patients with AF (2015-2022), including those with pre-existing, intrapartum, or periparturient AF. Adverse outcomes were postpartum tachyarrhythmias (within 1 year) or major cardiovascular events (MI, stroke, HF admissions within 2 years). Patients were categorized based on the presence of adverse outcomes, and their management strategies were compared. RESULTS Seventy patients with 82 pregnancies were included (7 pregnancies (8.5%) with adverse outcomes, 75 (91.5%) without). Among pregnancies with pre-existing AF, those with adverse outcomes more often had prior ablation (50.0% vs. 23.9%, P< 0.01) and cardioversion (75.0% vs. 2.2%, P< 0.01). Those with adverse outcomes also had higher rates of intrapartum/periparturient AF treatment (85.7% vs. 45.3%, P=0.04) and rhythm control (28.6% vs. 4.0%, P< 0.01). No differences were seen in rate control (57.1% vs. 44.0%, P=0.50), cardioversion during pregnancy (14.3% vs. 6.7%, P=0.46), or antithrombotic use (intrapartum/periparturient: 42.9% vs. 22.7%, P=0.40; postpartum: 0.0% vs. 9.3%, P=0.40). CONCLUSION Pregnancies with adverse outcomes had more prior interventions and intrapartum/periparturient AF treatment but similar antithrombotic use compared to those without adverse outcomes.

Volume

87

Issue

13 Suppl

First Page

A1075

Comments

American College of Cariology 75th Annual Scientific Session & Expo, March 28-30, 2026, New Orleans, LA

Last Page

A1075

DOI

10.1016/j.jacc.2026.02.2638

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