CVM Cardiovascular Medicine 1664-204X 1664-2031 EMH Schweizerischer Ärzteverlag AG Farnsburgerstrasse 8 CH-4132 Muttenz 02255 10.4414/cvm.2023.02255 Case report Arrhythmias Management of a recurrent pregnancy-related incessant adenosine-sensitive atrial tachycardia Thartori Albana albana.thartori@eoc.ch INTERNAL MEDICINE | San Giovanni Hospital: Ospedale Regionale di Bellinzona e Valli | Gallino 12, Bellinzona | Bellinzona | Switzerland | 6500 | SWITZERLAND Usardi Francesca SWITZERLAND Menafoglio Andrea SWITZERLAND Regoli François Diederik SWITZERLAND 22 03 2023 26 02 0 0 Copyright: EMH Schweizerischer Ärzteverlag AG 2023 EMH Schweizerischer Ärzteverlag AG "Cardiovascular Medicine" is an open access publication of EMH published in accordance with the terms of the Creative Commons licence attribution - NonCommercial - NoDerivatives 4.0 International. You are free to share, copy and redistribute the material in any medium or format under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial — You may not use the material for commercial purposes. NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material. "Non-commercial" means not primarily intended for or directed towards commercial advantage or monetary compensation. The incorporation of publications in commercial products, the use of publications to advertise for commercial products or services and any other usage that directly or indirectly pursues commercial interests is subject to the express previous consent of the publishing house as part of a written agreement. Please send us your request in writing. Exact indication of the publication from which you would like to reproduce material and detailed information about its intended use help to facilitate and expedite request processing.

Abstract A 27 year-old pregnant woman (29 th  week) was symptomatic for palpitations, dizziness and exertional dyspnea. The heart rate was 130 bpm at rest, up to 180 bpm during mild exertion, without hemodynamic compromise. The Electrocardiogram (ECG) showed atrial tachycardia (AT). With adenosine intermittent interruption of the AT was observed. Metoprolol combined with flecainide allowed to control the ventricular rate to 80-85 bpm followed by conversion to sinus rhythm. The patient was then no longer symptomatic until the second pregnancy, when the same AT recurred. Symptoms were controlled by combining metoprolol and flecainide at an earlier stage.