Impact of Premature Ventricular Contractions on Pregnancy and Delivery

Ventricular premature contractions and pregnancy issues?

Hello, Doctor.
I would like to ask about an incident that occurred around July.
One night, I suddenly woke up feeling like my heart skipped a beat.
I subsequently went to the cardiology department and wore a 24-hour Holter monitor, which recorded about 40 instances of atrial premature contractions (APCs) and ventricular premature contractions (VPCs).
The doctor said it was just an irregular heartbeat and there was no need for special concern as there was no life-threatening risk.
I was prescribed a beta-blocker to take half a tablet if I felt very uncomfortable.

Later, I had an echocardiogram.
Initially, the doctor suspected mitral valve prolapse, but after reviewing the echocardiogram report, he mentioned that my condition did not meet the strict criteria for mitral valve prolapse, although there was mild regurgitation.
He did not specify which valve was regurgitating, but he said it was not a major issue.
However, I have continued to occasionally feel that sensation of premature ventricular contractions (PVCs).
I am concerned whether the frequency of these could increase over the next three months.
Recently, in October, I found out I am pregnant (currently about 6 weeks along), and I have noticed that the sensation has become more pronounced.
Sometimes, while doing something, I suddenly feel a thump in my chest, as if I can't catch my breath.
I would like to ask if premature ventricular contractions pose any risks during pregnancy and delivery.
I have previously given birth without any symptoms or discomfort.
Would this be classified as a high-risk pregnancy? Thank you, and I apologize for the disturbance!

Xuanxuan, 20~29 year old female. Ask Date: 2022/10/28

Dr. He Dongjin reply Cardiology

Hello, having around 40 APCs (Atrial Premature Contractions) and VPCs (Ventricular Premature Contractions) in a 24-hour Holter monitor is generally considered acceptable.
Such ventricular ectopic beats are not likely to pose any significant risk during pregnancy and delivery.
If symptoms persist, you may consider repeating the 24-hour Holter monitor.
Take care, and Changhua Hospital is here for your well-being.

Reply Date: 2022/10/28

More Info

Premature Ventricular Contractions (PVCs) are a common type of heart arrhythmia that can occur in individuals, including pregnant women. They are characterized by early heartbeats originating from the ventricles, which can lead to a sensation of a skipped heartbeat or palpitations. While PVCs can be concerning, they are often benign, especially in the absence of underlying heart disease.

In your case, it seems that your PVCs were evaluated by a cardiologist, who indicated that they are not a cause for alarm and do not pose a significant risk to your health. The fact that you have experienced these sensations before pregnancy and that they have become more noticeable since conception is not uncommon. Hormonal changes during pregnancy, particularly increases in progesterone, can affect the heart and lead to heightened awareness of heartbeats or palpitations.

Regarding the impact of PVCs on pregnancy and delivery, it is important to note that most women with PVCs can have healthy pregnancies and deliveries. The key factors that determine whether a pregnancy is classified as high-risk include the presence of significant heart disease, structural heart abnormalities, or other medical conditions that could complicate pregnancy. Since your cardiologist has not indicated any serious concerns, it is likely that your pregnancy does not fall into the high-risk category solely due to PVCs.

However, it is essential to monitor your symptoms and communicate any changes to your healthcare providers. If you experience an increase in the frequency of PVCs, persistent chest pain, shortness of breath, or any other concerning symptoms, you should seek medical attention promptly. Regular follow-ups with both your obstetrician and cardiologist can help ensure that both your heart health and pregnancy are managed effectively.

In terms of delivery, PVCs typically do not interfere with the labor and delivery process. Most women with PVCs can deliver vaginally without complications. However, if there are any changes in your heart condition or if you develop other symptoms, your healthcare team may recommend specific monitoring during labor.

In summary, while PVCs can be uncomfortable and may cause anxiety, they are generally not a significant concern during pregnancy for most women. It is crucial to maintain open communication with your healthcare providers, adhere to any recommended follow-up appointments, and report any new or worsening symptoms. With appropriate management and monitoring, you can have a healthy pregnancy and delivery.

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