Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease
ABSTRACT 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 p...
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Wiley
2025-01-01
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| Series: | Annals of Noninvasive Electrocardiology |
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| Online Access: | https://doi.org/10.1111/anec.70037 |
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| author | Maria A. Pabon Amrit Misra Kimberlee Gauvreau Madeline E. Duncan Ava Conklin Katherine E. Economy Fred M. Wu Thomas Tadros Anne Marie Valente For the STORCC Investigators |
| author_facet | Maria A. Pabon Amrit Misra Kimberlee Gauvreau Madeline E. Duncan Ava Conklin Katherine E. Economy Fred M. Wu Thomas Tadros Anne Marie Valente For the STORCC Investigators |
| author_sort | Maria A. Pabon |
| collection | DOAJ |
| description | ABSTRACT 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. |
| format | Article |
| id | doaj-art-e526a95dcd624cf3b1dfd9cd2b1ba8ef |
| institution | Kabale University |
| issn | 1082-720X 1542-474X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Noninvasive Electrocardiology |
| spelling | doaj-art-e526a95dcd624cf3b1dfd9cd2b1ba8ef2025-01-28T05:38:41ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2025-01-01301n/an/a10.1111/anec.70037Electrocardiographic Changes in Pregnant Patients With Congenital Heart DiseaseMaria A. Pabon0Amrit Misra1Kimberlee Gauvreau2Madeline E. Duncan3Ava Conklin4Katherine E. Economy5Fred M. Wu6Thomas Tadros7Anne Marie Valente8For the STORCC InvestigatorsDivision of Cardiology, Department of Medicine Brigham and Women's Hospital Boston Massachusetts USADivision of Cardiology, Department of Medicine Brigham and Women's Hospital Boston Massachusetts USADepartment of Cardiology Boston Children's Hospital Boston Massachusetts USADivision of Cardiology, Department of Medicine Brigham and Women's Hospital Boston Massachusetts USADepartment of Cardiology Boston Children's Hospital Boston Massachusetts USADivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Brigham and Women's Hospital Boston Massachusetts USADivision of Cardiology, Department of Medicine Brigham and Women's Hospital Boston Massachusetts USADivision of Cardiology, Department of Medicine Brigham and Women's Hospital Boston Massachusetts USADivision of Cardiology, Department of Medicine Brigham and Women's Hospital Boston Massachusetts USAABSTRACT 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.https://doi.org/10.1111/anec.70037adult congenital heart diseasecongenital heart diseaseelectrocardiogramheart ratepregnancy |
| spellingShingle | Maria A. Pabon Amrit Misra Kimberlee Gauvreau Madeline E. Duncan Ava Conklin Katherine E. Economy Fred M. Wu Thomas Tadros Anne Marie Valente For the STORCC Investigators Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease Annals of Noninvasive Electrocardiology adult congenital heart disease congenital heart disease electrocardiogram heart rate pregnancy |
| title | Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease |
| title_full | Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease |
| title_fullStr | Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease |
| title_full_unstemmed | Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease |
| title_short | Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease |
| title_sort | electrocardiographic changes in pregnant patients with congenital heart disease |
| topic | adult congenital heart disease congenital heart disease electrocardiogram heart rate pregnancy |
| url | https://doi.org/10.1111/anec.70037 |
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