Maria A Pabon, Amrit Misra, Kimberlee Gauvreau, Madeline E Duncan, Ava Conklin, Katherine E Economy, Fred M Wu, Thomas Tadros, Anne Marie Valente
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EKG parameters were measured in all available EKGs by two investigators, blinded to diagnosis and time of gestation.</p><p><strong>Results: </strong>One hundred and seventy pregnant patients were included. There was a statistically significant increase in HR from pre-pregnancy to third trimester in all groups except for those with Fontan and SRV. Patients with ASD and BAV had a statistically significant increase in their QTc (ASD:13 ms, p = 0.017; BAV:7 ms, p = 0.018) during pregnancy. QRS duration was shorter (4 ms) in the third trimester for patients with ASD (p = 0.033) and CoA (p = 0.014). Despite these individual findings, EKG parameters remained within normal limits and regressed to baseline in the postpartum period.</p><p><strong>Conclusions: </strong>Patients with CHD have statistically significant EKG changes throughout pregnancy, but the values remain within normal limits. Like patients without heart disease, those with CHD increase their HR during pregnancy, except individuals with SRV and Fontan, who appear to lack capacity for physiologic HR augmentation.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 1","pages":"e70037"},"PeriodicalIF":1.1000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705495/pdf/","citationCount":"0","resultStr":"{\"title\":\"Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease\",\"authors\":\"Maria A Pabon, Amrit Misra, Kimberlee Gauvreau, Madeline E Duncan, Ava Conklin, Katherine E Economy, Fred M Wu, Thomas Tadros, Anne Marie Valente\",\"doi\":\"10.1111/anec.70037\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Electrocardiograms (EKGs) are routinely performed in pregnant patients with pre-existing cardiovascular disease. However, in pregnant patients with congenital heart disease (CHD), EKG changes during gestation have not been explored.</p><p><strong>Methods: </strong>We performed a retrospective study of pregnant patients with CHD enrolled in the STORCC initiative. Patients were included if they had at least two EKGs across the perinatal period and were grouped by specific conditions: atrial septal defect (ASD), tetralogy of Fallot, congenital pulmonary stenosis, coarctation of the aorta (CoA), bicuspid aortic valve (BAV), systemic right ventricle (SRV), and Fontan circulation. EKG parameters were measured in all available EKGs by two investigators, blinded to diagnosis and time of gestation.</p><p><strong>Results: </strong>One hundred and seventy pregnant patients were included. There was a statistically significant increase in HR from pre-pregnancy to third trimester in all groups except for those with Fontan and SRV. Patients with ASD and BAV had a statistically significant increase in their QTc (ASD:13 ms, p = 0.017; BAV:7 ms, p = 0.018) during pregnancy. QRS duration was shorter (4 ms) in the third trimester for patients with ASD (p = 0.033) and CoA (p = 0.014). Despite these individual findings, EKG parameters remained within normal limits and regressed to baseline in the postpartum period.</p><p><strong>Conclusions: </strong>Patients with CHD have statistically significant EKG changes throughout pregnancy, but the values remain within normal limits. 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引用次数: 0
摘要
背景:心电图(EKGs)是妊娠期已有心血管疾病患者的常规检查。然而,在患有先天性心脏病(CHD)的妊娠患者中,尚未探讨妊娠期间的心电图变化。方法:我们对参加STORCC计划的怀孕冠心病患者进行了回顾性研究。如果患者在围产期至少有两次心电图,并根据具体情况进行分组:房间隔缺损(ASD)、法洛四联症、先天性肺动脉狭窄、主动脉缩窄(CoA)、二尖瓣主动脉瓣(BAV)、系统性右心室(SRV)和Fontan循环。在所有可用的心电图参数测量由两名调查员,盲诊断和妊娠时间。结果:纳入170例孕妇。除Fontan和SRV组外,所有组从孕前到妊娠晚期的HR均有统计学意义的增加。ASD和BAV患者的QTc增加具有统计学意义(ASD:13 ms, p = 0.017;BAV:7 ms, p = 0.018)。ASD (p = 0.033)和CoA (p = 0.014)患者妊娠晚期QRS持续时间较短(4 ms)。尽管有这些个体的发现,心电图参数仍在正常范围内,并在产后回归到基线。结论:冠心病患者妊娠期心电图变化具有统计学意义,但仍在正常范围内。与没有心脏病的患者一样,CHD患者在怀孕期间心率增加,但SRV和Fontan患者似乎缺乏生理性心率增加的能力。
Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease
Background: Electrocardiograms (EKGs) are routinely performed in pregnant patients with pre-existing cardiovascular disease. However, in pregnant patients with congenital heart disease (CHD), EKG changes during gestation have not been explored.
Methods: We performed a retrospective study of pregnant patients with CHD enrolled in the STORCC initiative. Patients were included if they had at least two EKGs across the perinatal period and were grouped by specific conditions: atrial septal defect (ASD), tetralogy of Fallot, congenital pulmonary stenosis, coarctation of the aorta (CoA), bicuspid aortic valve (BAV), systemic right ventricle (SRV), and Fontan circulation. EKG parameters were measured in all available EKGs by two investigators, blinded to diagnosis and time of gestation.
Results: One hundred and seventy pregnant patients were included. There was a statistically significant increase in HR from pre-pregnancy to third trimester in all groups except for those with Fontan and SRV. Patients with ASD and BAV had a statistically significant increase in their QTc (ASD:13 ms, p = 0.017; BAV:7 ms, p = 0.018) during pregnancy. QRS duration was shorter (4 ms) in the third trimester for patients with ASD (p = 0.033) and CoA (p = 0.014). Despite these individual findings, EKG parameters remained within normal limits and regressed to baseline in the postpartum period.
Conclusions: Patients with CHD have statistically significant EKG changes throughout pregnancy, but the values remain within normal limits. Like patients without heart disease, those with CHD increase their HR during pregnancy, except individuals with SRV and Fontan, who appear to lack capacity for physiologic HR augmentation.
期刊介绍:
The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients.
ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation.
ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.