Enhanced tendency for arrhythmias in pregnancy

Enhanced tendency for arrhythmias in pregnancy

In general there is an enhancement of tendency for arrhythmias in pregnancy. Isolated ventricular ectopic beats are probably the commonest arrhythmia in pregnancy.

The hemodynamic changes of pregnancy, enhanced hormonal levels, alterations in autonomic tone and increased sensitivity to circulating sympathomimetic amines are some of the factors considered as causative factor for enhanced arrhythmogenicity in pregnancy. Presence of hypokalemia and associated structural heart disease can also increase the chance of arrhythmias in pregnancy.

Arrhythmia in pregnancy may occur as a recurrence of previously known arrhythmia or new occurrence of arrhythmia in those with known structural heart disease [1]. But if there is no previously documented heart disease, occurrence of arrhythmia can cause significant anxiety. But most of the arrhythmias in pregnancy are benign and just troublesome, requiring only reassurance.

Judicious use of anti arrhythmic medications may be needed in a minority of cases. But arrhythmia in those with structural heart disease is of much more higher concern and should be cautiously managed. Arrhythmia is one of the five independent predictors of having a cardiac event during pregnancy [1].

References

1. Dawn L Adamson, Catherine Nelson-Piercy. Managing Palpitations and Arrhythmias During Pregnancy. Heart. 2007 Dec;93(12):1630-6.