Shotan A, Ostrzega E, Mehra A, Johnson J V, Elkayam U
Department of Medicine, University of Southern California School of Medicine, Los Angeles 90033, USA.
Am J Cardiol. 1997 Apr 15;79(8):1061-4. doi: 10.1016/s0002-9149(97)00047-7.
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.
我们评估了110例因心悸、头晕和晕厥前来评估且无心脏病证据的连续妊娠患者（研究组）以及52例因无症状功能性心前区杂音前来评估的连续患者（对照组）的症状与心律失常之间的关系。两组患者动态心电图监测的心律失常发生率均较高，研究组房性早搏（APC）发生率为56%，对照组为58%；分别有7%和4%的患者APC>100次，室性早搏（VPC）孤立性发作率分别为59%和50%。研究组孤立性VPC数量更多，更多患者每小时VPC>50次（24小时内分别为3235±6397次与678±3358次，p<0.05；分别为22%与2%，p=0.03）。同样，研究组患者多灶性VPC发生率更高（12%与2%，p<0.05）。VPC或APC的发生率与症状之间无相关性，仅10%的症状发作伴有心律失常。对9例孕期有多次早搏的女性产后6周进行重复动态心电图监测（9073±9210/24小时），结果显示大幅降至1345±1997/24小时（p<0.05）。因此，本研究证实正常妊娠期间心律失常发生率增加。这些心律失常主要由APC和VPC组成。有心悸、头晕或晕厥症状的患者单纯性和多灶性VPC数量更多；然而，心律失常的发生率与症状之间无相关性，仅10%的症状发作伴有心律失常。
