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Original research article
Impact of frequent premature ventricular contractions on pregnancy outcomes
  1. Calvin Tong1,
  2. Marla Kiess1,
  3. Marc William Deyell1,
  4. Michael Qiu1,
  5. Merav Orgad1,
  6. Valerie Rychel2,
  7. Ariel Claman1,
  8. Emma Hardwick1,
  9. Beverly McCarthy1,
  10. Candice K Silversides3,
  11. Jasmine Grewal1
  1. 1 Division of Cardiology, St Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2 Department of Obstetrics and Gynecology, St Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3 Division of Cardiology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Jasmine Grewal, Division of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada; jasmine.grewal{at}vch.ca

Abstract

Objectives To determine cardiac and fetal/neonatal event rates among pregnant women with premature ventricular contractions (PVCs) and compare with control groups.

Methods Prospective case–control cohort study: 53 consecutive pregnancies in 49 women referred to the St. Paul’s Hospital between 2010 and 2016 with PVC burden >1% in women without underlying cardiac disease. Maternal cardiac and fetal/neonatal outcomes were compared with two pregnant control groups: (1) supraventricular tachycardia (SVT) group of 53 women referred for a history of SVT/SVT in the current pregnancy and (2) low-risk group of 53 women with no cardiac disease.

Results The maximal PVC burden was 9.2% (range 1.1%–58.7%). Six of 53 (11%) pregnancies were complicated by a maternal cardiac event: heart failure n=1 and sustained ventricular tachycardia requiring therapy n=5 as compared with no cardiac events in both control groups. All women with an adverse event had a PVC burden >5%. Seven (13%) pregnancies were complicated by an adverse fetal and/or neonatal event and this was similar to the normal control group (5 (9%), P=0.45) and significantly less than the SVT group (16 (30%), P=0.03). The adverse fetal event was driven by small for gestational age neonates and preterm delivery.

Conclusions In our cohort of pregnant women with a structurally normal heart and ‘high’ PVC burden, we found an adverse maternal event rate of 11%, and all events were successfully managed with medical therapy. The rate of adverse fetal events in the PVC group was similar to the normal control group.

  • pregnancy
  • premature ventricular beats

https://doi.org/10.1136/heartjnl-2017-312624

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    Footnotes

    • Contributors CT collected patient data and assisted in manuscript writing. MK identified patients in clinic and provided critical feedback on the manuscript. MD was involved in study design and manuscript review. MO, MQ and AC assisted with data collection. EH and BM identified patients in clinic and recruited them for the study. CS was involved in study design and manuscript review. JG was involved in study design, data review, statistical analysis and manuscript writing.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Ethics approval Obtained from the University of British Columbia Research Ethics Board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No unpublished data available.