INCIDENCE OF ARRHYTHMIAS IN NORMAL-PREGNANCY AND RELATION TO PALPITATIONS, DIZZINESS, AND SYNCOPE

We assessed the relation between symptoms and cardiac arrhythmias in 1 10 consecutive pregnant patients without evidence of heart disease ref erred for evaluation of palpitations, dizziness, and syncope (study gr oup) and in 52 consecutive patients referred for evaluation of an asym ptomatic functional precordial murmur (control group). Both groups had a high incidence of arrhythmias on Halter monitoring with atrial prem ature complexes (APCs) of 56% in the study group and 58% in the contro l group, >100 APCs in 7% and 4% of the patients, respectively, and iso lated ventricular premature complexes (VPCs) in 59% and 50%, respectiv ely. The number of isolated VPCs was higher and >50 VPCs/hour were see n in more patients in the study group (3,235 +/- 6,397 vs 678 +/- 3,35 8 beats/24 hours p < 0.05 and 22% vs 2% p = 0.03). Similarly, the inci dence 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 accom panied by the presence of arrhythmias. Repeated Holter monitoring 6 we eks 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 inc reased incidence of arrhythmias during normal pregnancy. These arrhyth mias consist mostly of APCs and VPCs. The number of simple and multifo cal VPCs is higher in patients presenting with symptoms of palpitation s, dizziness, or syncope; however, there is no correlation between the incidence of arrhythmias and symptoms, and only 10% of symptomatic ep isodes were accompanied by the presence of arrhythmias. (C) 1997 by Ex cerpta Medica, Inc.