21 - Palpitations during pregnancy

Summary

A study looking at the incidence of arrhythmias in normal pregnancy and relation to palpitations, dizziness and syncope demonstrated a high incidence of arrhythmias, mostly ventricular ectopic activity, in young healthy women presenting with symptoms of palpitations, dizziness or syncope during their pregnancy. Before initiating therapy, it is important to correctly diagnose the type and mechanism of the underlying arrhythmia so that proper therapeutic modalities can be implemented. In the event of the patient having palpitations at the time of electrocardiogram (ECG), diagnosis of arrhythmia can be confirmed. Women who have had repair of their congenital heart defects have an increased risk of arrhythmias during pregnancy. Cardioversion is safe during all trimesters of pregnancy and can be used if necessary. Pharmacological therapy of rhythm disorders should be reserved for arrhythmias resulting in maternal or fetal haemodynamic compromise and for arrhythmias with intolerable symptoms.