The risk of arrhythmia by calculating with new electrocardiographic parameters in pregnant women with heart failure

Abstract

Aim: To evaluate cardiac arrhythmias with surface 12 lead electrocardiography (ECG) parameters during pregnancy in women with mild heart failure. Material and Cardiovascular deaths usually occur in older pregnancies and arrhythmia is the third most common cause. Our study aimed to determine whether the risk of arrhythmia increases in pregnancy with advanced age.Go to:Methods:This cross-sectional study was approved by the local ethics committee of bicard clinic and our hospital 53 consecutive patients were accepted. All patients were admitted to hospital for cesarean section. Patients were grouped to heart failure (group 1) and control (group 2) (healthy group). A 12 lead ECG and N-terminal pro B-type natriuretic peptide (NT-pro BNP) plasma levels was recorded for every woman at 48 hour before cesarean section. They were evaluated P wave, qt, qtc and Twave peak to end, preoperative NT-pro BNP and compared statistically.In total, 280 pregnant women, of whom 98 were of advanced age and 182 were under 35 years of age were included in the study. The risk of arrhythmia was evaluated by calculating the electrocardiographic P-wave duration, QT interval, T peak-to-end interval, and the Tp-e/QT ratio.Go to:Results: There were statistically significant differences in the Tp–e interval and Tp-e/QTc ratio between the two groups, the maximum QTc, minimum QTc, and QTc dispersion values, P wave dispersion were significantly higher in group-1 compared to the group-2. In addition, preoperative NT-pro BNP plasma levels was greater in the group 1 pregnant women. And there was a positive correlation between ECG parameters and NT-pro BNP plasma levels in group 1.Although there were no differences in the Tp-e interval and Tp-e/QTc ratio between the groups, the maximum QTc, minimum QTc, and QTc dispersion values were significantly higher in advanced-age pregnancies compared to the control group. In addition, the P dispersion was greater in advanced-age pregnancies. In correlation analysis, the increased dispersion of QTc and P were positively correlated with maternal age. Multiple linear regression analysis showed that QTc dispersion was independently associated with maternal age.Go to: Conclusion: In conclusion, repolarization parameters were increased in patients with heart failure with elevated NT-pro BNP. Pregnancy and heart failure has known risk for pregnant women. But there is no clear cut atrial and ventricular arrhythmias risk scoring parameters for these kind patients. We found that ECG parameters which had significantly different in pregnant women with heart failure than control group and these changes correlated with NT-pro BNP levels. This is pathological; arrhythmia risk scorings should be established to reduce mortality and morbidity in heart failure patients with elevated BNP levels.