How often should follow-up ECG be performed on a pregnant patient with atrial fibrillation (AF) that resolves with medication that is then discontinued? — Connie Kelly, FNP, Franklin, N.Y.

The first factor to consider in such a patient is whether the echo indicates a normal left atrium. If so, think about a 14-day cardiac monitor for asymptomatic AF. Pregnancy is a hypercoagulation time frame, and stroke prevention may need to be considered.

The Zio Patch is a minimal invasive cardiac rhythm monitor. Consult an electrophysiologist when treating AF during pregnancy. Monitor rhythm during labor, as AF decreases cardiac output, which can affect the unborn child. If abnormalities are detected in the echo, consult an electrophysiologist. — Maria Kidner, DNP, FNP-C (156-1)