Electrocardiographic indices and pregnancy: A focus on changes between first and third trimesters

Omidi, Negar; Khorgami, Mohammadrafie; Khatami, Farnaz; Mahalleh, Mehrdad

doi:10.1016/j.repc.2021.02.018

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…A previous study reported that PR interval decreased in the third trimester. The shortening of PR indicates an acceleration of atrioventricular node conduction velocity due to increased sympathetic activity resulting in tachycardia [ 43 ]. Sex hormone such as estrogen can alter the electrophysiological properties of the myocardium and changes in ventricular repolarization result in lengthening of the QT interval during pregnancy [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…A previous study reported that PR interval decreased in the third trimester. The shortening of PR indicates an acceleration of atrioventricular node conduction velocity due to increased sympathetic activity resulting in tachycardia [43]. Sex hormone such as estrogen can alter the the balance of sympathetic and parasympathetic tone in horses [23] and thus was evaluated in this study.…”

Section: Discussionmentioning

confidence: 99%

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Effects of pregnancy on electrocardiographic, vasovagal tonus index, and echocardiographic variables in horses

Chompoosan,

Pongthaisong,

Kenchaiwong

et al. 2023

Vet World

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Background and Aim: Pregnancy affects maternal hemodynamics. The changes in autonomic nervous system activity for hemodynamics adaptation in pregnant horses are still unclear. Thus, this study aimed to examine the effect of pregnancy on electrocardiographic, vasovagal tonus index, and echocardiographic variables in horses. Materials and Methods: A total of 23 Thai native crossbred mares without any cardiac abnormalities were included in this study. The animals were assigned into two groups, a non-pregnant mare group (n =12) and a pregnant mare group (n = 11). Electrocardiogram recordings (paper speed = 25 mm/s and calibration = 10 mm/mV) were performed to obtain six limb leads (leads I, II, III, aVR, aVL, and aVF). The vasovagal tonus index (VVTI) was calculated to assess variability in heart rate over short periods using just 20 consecutive beats. Cardiac structure and function were evaluated by echocardiography. Results: Heart rate, P wave duration, PR interval, QRS duration, QT interval, and T wave duration were significantly different between non-pregnant and pregnant horses (p < 0.05). Pregnant horses had significantly lower VVTI than non-pregnant (p < 0.05). There were no significant differences in cardiac structures including % interventricular septum (IVS), % left ventricular posterior wall (LVPW), IVS in diastole, left ventricular internal diameter at end-diastole, LVPW thickness at end-diastole, IVS in systole, left ventricular internal diameter at end-systole, LVPW thickness at end-systole, and left atrium/aortic roots ratio between the two groups. However, the pregnant horses had a significantly higher cardiac output and % ejection fraction than non-pregnant horses (p < 0.05). Conclusion: This study provided the first evidence that hemodynamic adaptations during pregnancy modified cardiac conduction, vasovagal tonus index, and echocardiographic variables in horses. Keywords: echocardiography, electrocardiogram, horses, pregnancy, vasovagal tonus index.

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Section: Discussionmentioning

confidence: 99%

“…A previous study reported that PR interval decreased in the third trimester. The shortening of PR indicates an acceleration of atrioventricular node conduction velocity due to increased sympathetic activity resulting in tachycardia [43]. Sex hormone such as estrogen can alter the the balance of sympathetic and parasympathetic tone in horses [23] and thus was evaluated in this study.…”

Section: Discussionmentioning

confidence: 99%

Effects of pregnancy on electrocardiographic, vasovagal tonus index, and echocardiographic variables in horses

Chompoosan,

Pongthaisong,

Kenchaiwong

et al. 2023

Vet World

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“…10 As a result of increased metabolic demands and sympathetic activity during pregnancy, heart rate increases in normal pregnancy by 15-25% starting early and peaking in the third trimester. 19 Accordingly, the PR-and QT intervals as well as QRS duration decrease, but remain within the normal range during a normal pregnancy. 14,20 As the QT interval decreases with increasing heart rate, the reported QT interval is usually reported as a function of heart rate, the so-called QTc.…”

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confidence: 99%

“…22 Previous studies have shown that QTc increases during pregnancy without previous cardiac disease although remain within the normal range. 8,14,19,20 A study comparing QT and QTc intervals between 40 pregnant and 40 non-pregnant women without previous heart disease found a mean difference of 27 ms between QTc in the two cohorts. 8 In this study, the mean QTc in the pregnant group was 430 ms compared to 403 in the non-pregnant group.…”

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confidence: 99%

Electrocardiographic proarrhythmic changes in pregnancy of women with CHD

Weismann,

Wedlund,

Ryd

et al. 2024

Cardiol Young

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Objectives: Pregnancy-related physiological adaptations result in increased heart rate as well as electrocardiographic changes such as a mean QTc prolongation of 27 ms. Pregnant women with CHD are at increased risk for cardiovascular complications. The aim of this study was to identify risk factors for abnormally prolonged QTc interval—a risk factor for ventricular arrhythmias—in pregnant women with CHD. Material and method: Retrospective longitudinal single-centre study. Pre-pregnancy demographic and electrocardiographic risk factors for abnormal QTc duration during pregnancy of (a) > 460 ms and (b) >27 ms increase were analyzed. Results: Eighty-three pregnancies in 63 women were included, of which three had documented arrhythmias. All five Modified World Health Organization Classification of Maternal Cardiovascular Risk (mWHO) classes were represented, with 15 pregnancies (18.1%) in mWHO class I, 26 (31.3%) in mWHO II, 28 (33.7%) in mWHO II-III, 11 (13.3%) in mWHO III, and three pregnancies (3.6%) in mWHO class IV. Heart rate and QTc interval increased, while QRS duration and PR interval shortened during pregnancy. QTc duration of > 460 ms was associated with increased pre-pregnancy QTc interval, QRS duration, and weight, as well as body mass index. QTc increase of > 27 ms was associated with increased heart rate prior to pregnancy. No significant associations of electrocardiographic changes with mWHO class or CHD type were identified. Conclusion: Increased QTc in pregnant women with CHD was associated with being overweight or having higher heart rate, QRS, or QTc duration prior to pregnancy. These patients should be monitored closely for arrhythmias during pregnancy.

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Pregnancy and electrocardiogram: Can a basic tool help us to understand a complex and understudied population?

Monteiro

2022

Revista Portuguesa de Cardiologia

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Electrocardiographic indices and pregnancy: A focus on changes between first and third trimesters

Cited by 4 publications

References 24 publications

Effects of pregnancy on electrocardiographic, vasovagal tonus index, and echocardiographic variables in horses

Effects of pregnancy on electrocardiographic, vasovagal tonus index, and echocardiographic variables in horses

Electrocardiographic proarrhythmic changes in pregnancy of women with CHD

Pregnancy and electrocardiogram: Can a basic tool help us to understand a complex and understudied population?

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