The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
Incidence of Arrhythmias in Normal Pregnancy and Relation to Palpitations, Dizziness, and Syncope
Abstract
We assessed the relation between symptoms and cardiac arrhythmias in 110 consecutive pregnant patients without evidence of heart disease referred for evaluation of palpitations, dizziness, and syncope (study group) and in 52 consecutive patients referred for evaluation of an asymptomatic functional precordial murmur (control group). Both groups had a high incidence of arrhythmias on Holter monitoring with atrial premature complexes (APCs) of 56% in the study group and 58% in the control group, > 100 APCs in 7% and 4% of the patients, respectively, and isolated ventricular premature complexes (VPCs) in 59% and 50%, respectively. The number of isolated VPCs was higher and > 50 VPCs/hour were seen in more patients in the study group (3,235 +/- 6,397 vs 678 +/- 3,358 beats/24 hours p < 0.05 and 22% vs 2% p = 0.03). Similarly, the incidence of multifocal VPCs was higher in the study patients (12% vs 2%, p < 0.05). There was no correlation between the incidence of both VPCs or APCs and symptoms, and only 10% of symptomatic episodes were accompanied by the presence of arrhythmias. Repeated Holter monitoring 6 weeks postpartum in 9 women with multiple premature contractions during pregnancy (9,073 +/- 9,210/24 hours) showed a substantial reduction to 1,345 +/- 1,997/24 hours (p < 0.05). Thus, this study confirms an increased incidence of arrhythmias during normal pregnancy. These arrhythmias consist mostly of APCs and VPCs. The number of simple and multifocal VPCs is higher in patients presenting with symptoms of palpitations, dizziness, or syncope; however, there is no correlation between the incidence of arrhythmias and symptoms, and only 10% of symptomatic episodes were accompanied by the presence of arrhythmias.
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“A higher frequency of atrial and ventricular premature extra systoles may also serve as triggers of SVT episodes.399”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [399]
Citations
Cites
Adaptation of the maternal heart in pregnancy
Hunter, S. K., & Robson, S. C. (1992) · Heart · doi:10.1136/hrt.68.12.540 · Cited by 604
New-onset ventricular tachycardia during pregnancy
Brodsky, M. A., Doria, R. J., Allen, B. J., Sato, D. A., Thomas, G. D., & Sada, M. J. (1992) · American Heart Journal · doi:10.1016/0002-8703(92)90699-v · Cited by 164
Plasma catecholamine responses to physiologic stimuli in normal human pregnancy
Barron, W. M., MUJAIS, S. K., Zinaman, M. J., Bravo, E. L., & Lindheimer, M. D. (1986) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(86)90397-2 · Cited by 148
Effect of pregnancy on paroxysmal supraventricular tachycardia
Tawam, M., Levine, J., Mendelson, M., Goldberger, J., Dyer, A., & Kadish, A. (1993) · The American Journal of Cardiology · doi:10.1016/0002-9149(93)91078-v · Cited by 144
WPW syndrome during pregnancy: increased incidence of supraventricular arrhythmias
Widerhorn, J., Widerhorn, A. L. M., Rahimtoola, S. H., & Elkayam, U. (1992) · American Heart Journal · doi:10.1016/0002-8703(92)90526-2 · Cited by 127
Disorders of the heartbeat during pregnancy
Mendelson, C. L. (1956) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(56)90787-6 · Cited by 81
Engel, E. L. (1991) · CHEST Journal · doi:10.1016/s0012-3692(16)37461-x · Cited by 78
Plasma noradrenaline and adrenaline levels in normal pregnancy and in pregnancy‐induced hypertension
Natrajan, P. G., McGARRTGLE, H. H. G., Lawrence, D. M., & Lachelin, G. C. L. (1982) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1982.tb04661.x · Cited by 61
PAROXYSMAL TACHYCARDIA IN PREGNANCY
Szekely, P., & Snaith, L. (1953) · Heart · doi:10.1136/hrt.15.2.195 · Cited by 55
Wolff-Parkinson-White syndrome in pregnancy
Gleicher, N., Meller, J., Sandler, R. Z., & Sullum, S. (1983) · Journal of Emergency Medicine · doi:10.1016/0736-4679(83)90015-x · Cited by 49
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Priori, S. G., Blomström-Lundqvist, C., Mazzanti, A., Blom, N., Borggrefe, M., Camm, J., Elliott, P. M., Fitzsimons, D., Hatala, R., Hindricks, G., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv316 · Cited by 3,893
Authors Task Force Members, Priori, S. G., Blomström‐Lundqvist, C., Mazzanti, A., Blom, N. A., Borggrefe, M., Camm, J. A., Elliot, P. M., Fitzsimons, D., Hatala, R., et al. (2015) · EP Europace · doi:10.1093/europace/euv319 · Cited by 1,671
Blomström‐Lundqvist, C., Scheinman, M. M., Aliot, E., Alpert, J. S., Calkins, H. G., Camm, A. J., Campbell, W. B., Haines, D. E., Kück, K., Lerman, B. B., et al. (2003) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2003.08.013 · Cited by 684
The effect of valvular heart disease on maternal and fetal outcome of pregnancy
Hameed, A. B., Karaalp, I. S., Tummala, P. P., Wani, O. R., Canetti, M., Akhter, M. W., Goodwin, M., Zapadinsky, N., & Elkayam, U. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)01198-0 · Cited by 440
2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia
Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes, N. A. M., Field, M. E., Goldberger, Z. D., Hammill, S. C., et al. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.08.856 · Cited by 439
Metadata
- Authors
- Shotan, A., Ostrzega, E., Mehra, A., Johnson, J. V., & Elkayam, U.
- Affiliations
- University of Southern California (US)
- ORCID
- Elkayam, Uri
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 1997-04
- Volume
- 79
- Issue
- 8
- Pages
- 1061-1064
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2153087932
- Cited by
- 267
- References
- 18
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 8 · 2023: 14 · 2022: 15 · 2021: 19 · 2020: 15 · 2019: 14 · 2018: 9 · 2017: 19 · 2016: 16 · 2015: 17 · 2014: 7 · 2013: 8 · 2012: 10
- FWCI
- 0.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Issues in Pregnancy
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- cardiac arrhythmias in pregnancy, premature atrial contractions, premature ventricular contractions, palpitations, dizziness, syncope, Holter monitoring, asymptomatic arrhythmia
- MeSH terms
- Adolescent, Adult, Arrhythmias, Cardiac, Dizziness, Female, Humans, Pregnancy, Pregnancy Complications, Cardiovascular, Syncope, Electrocardiography, Ambulatory, Incidence
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