BACKGROUND: Terbutaline has direct effects on the cardiac conduction system, but when used to treat preterm labor it is rarely associated with clinically significant cardiac arrhythmias. Commonly used drug references did not list atrial fibrillation as a complication of terbutaline, and our literature search found only one case of atrial fibrillation that occurred with parenteral administration.
CASE: A 30-year-old gravida 1 carrying a twin gestation at 35 weeks was taking 2.5 mg oral terbutaline four times daily for premature labor. She developed atrial fibrillation and was ultimately treated by chemical cardioversion with procainamide to restore normal sinus rhythm.
CONCLUSION: This is the first report of atrial fibrillation during pregnancy associated with oral terbutaline. Atrial fibrillation should be added as a complication of oral terbutaline therapy.