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Changes in heart rate variability and QT variability during the first trimester of pregnancy

R E Carpenter, L A D’Silva, S J Emery, O Uzun, D Rassi, M J Lewis, Dareyoush Rassi, Michael Lewis

Physiological Measurement, Volume: 36, Issue: 3, Pages: 531 - 545

Swansea University Authors: Dareyoush Rassi, Michael Lewis

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DOI (Published version): 10.1088/0967-3334/36/3/531

Abstract

The risk of new-onset arrhythmia during pregnancy is high, presumably relating to changes in both haemodynamic and cardiac autonomic function. The ability to non-invasively assess an individual's risk of developing arrhythmia during pregnancy would therefore be clinically significant. We aimed...

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Published in: Physiological Measurement
ISSN: 0967-3334 1361-6579
Published: 2015
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URI: https://cronfa.swan.ac.uk/Record/cronfa21301
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2018-05-01T08:26:28.5486329</datestamp><bib-version>v2</bib-version><id>21301</id><entry>2015-05-11</entry><title>Changes in heart rate variability and QT variability during the first trimester of pregnancy</title><swanseaauthors><author><sid>51c422f16640bfafd521eb6e1395265d</sid><firstname>Dareyoush</firstname><surname>Rassi</surname><name>Dareyoush Rassi</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>b59c8f5c056bac7e6995385f22ad1639</sid><firstname>Michael</firstname><surname>Lewis</surname><name>Michael Lewis</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2015-05-11</date><deptcode>FGMHL</deptcode><abstract>The risk of new-onset arrhythmia during pregnancy is high, presumably relating to changes in both haemodynamic and cardiac autonomic function. The ability to non-invasively assess an individual's risk of developing arrhythmia during pregnancy would therefore be clinically significant. We aimed to quantify electrocardiographic temporal characteristics during the first trimester of pregnancy and to compare these with non-pregnant controls.Ninety-nine pregnant women and sixty-three non-pregnant women underwent non-invasive cardiovascular and haemodynamic assessment during a protocol consisting of various physiological states (postural manoeurvres, light exercise and metronomic breathing). Variables measured included stroke volume, cardiac output, heart rate, heart rate variability, QT and QT variability and QTVI (a measure of the variability of QT relative to that of RR).Heart rate (p &amp;#60; 0.0005, p &amp;#60; 0.0005, p &amp;#60; 0.0005) and cardiac output (p = 0.043, p &amp;#60; 0.0005, p &amp;#60; 0.0005) were greater in pregnant women in all physiological states (respectively for the supine position, light exercise and metronomic breathing state), whilst stroke volume was lower in pregnancy only during the supine position (p &amp;#60; 0.0005). QTe (Q wave onset to T wave end) and QTa (T wave apex) were significantly shortened (p &amp;#60; 0.05) and QTeVI and QTaVI were increased in pregnancy in all physiological states (p &amp;#60; 0.0005). QT variability (p &amp;#60; 0.002) was greater in pregnant women during the supine position, whilst heart rate variability was reduced in pregnancy in all states (p &amp;#60; 0.0005).Early pregnancy is associated with substantial changes in heart rate variability, reflecting a reduction in parasympathetic tone and an increase in sympathetic activity. QTVI shifted to a less favourable value, reflecting a greater than normal amount of QT variability. QTVI appears to be a useful method for quantifying changes in QT variability relative to RR (or heart rate) variability, being sensitive not only to physiological state but also to gestational age. We support the use of non-invasive markers of cardiac electrical variability to evaluate the risk of arrhythmic events in pregnancy, and we recommend the use of multiple physiological states during the assessment protocol.</abstract><type>Journal Article</type><journal>Physiological Measurement</journal><volume>36</volume><journalNumber>3</journalNumber><paginationStart>531</paginationStart><paginationEnd>545</paginationEnd><publisher/><issnPrint>0967-3334</issnPrint><issnElectronic>1361-6579</issnElectronic><keywords/><publishedDay>18</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2015</publishedYear><publishedDate>2015-02-18</publishedDate><doi>10.1088/0967-3334/36/3/531</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2018-05-01T08:26:28.5486329</lastEdited><Created>2015-05-11T08:38:23.5945765</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Engineering and Applied Sciences - Uncategorised</level></path><authors><author><firstname>R E</firstname><surname>Carpenter</surname><order>1</order></author><author><firstname>L A</firstname><surname>D&#x2019;Silva</surname><order>2</order></author><author><firstname>S J</firstname><surname>Emery</surname><order>3</order></author><author><firstname>O</firstname><surname>Uzun</surname><order>4</order></author><author><firstname>D</firstname><surname>Rassi</surname><order>5</order></author><author><firstname>M J</firstname><surname>Lewis</surname><order>6</order></author><author><firstname>Dareyoush</firstname><surname>Rassi</surname><order>7</order></author><author><firstname>Michael</firstname><surname>Lewis</surname><order>8</order></author></authors><documents><document><filename>0021301-22102015103744.pdf</filename><originalFilename>Carpenter2015v2.pdf</originalFilename><uploaded>2015-10-22T10:37:44.1630000</uploaded><type>Output</type><contentLength>915905</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2015-10-22T00:00:00.0000000</embargoDate><documentNotes/><copyrightCorrect>false</copyrightCorrect></document></documents><OutputDurs/></rfc1807>
spelling 2018-05-01T08:26:28.5486329 v2 21301 2015-05-11 Changes in heart rate variability and QT variability during the first trimester of pregnancy 51c422f16640bfafd521eb6e1395265d Dareyoush Rassi Dareyoush Rassi true false b59c8f5c056bac7e6995385f22ad1639 Michael Lewis Michael Lewis true false 2015-05-11 FGMHL The risk of new-onset arrhythmia during pregnancy is high, presumably relating to changes in both haemodynamic and cardiac autonomic function. The ability to non-invasively assess an individual's risk of developing arrhythmia during pregnancy would therefore be clinically significant. We aimed to quantify electrocardiographic temporal characteristics during the first trimester of pregnancy and to compare these with non-pregnant controls.Ninety-nine pregnant women and sixty-three non-pregnant women underwent non-invasive cardiovascular and haemodynamic assessment during a protocol consisting of various physiological states (postural manoeurvres, light exercise and metronomic breathing). Variables measured included stroke volume, cardiac output, heart rate, heart rate variability, QT and QT variability and QTVI (a measure of the variability of QT relative to that of RR).Heart rate (p &#60; 0.0005, p &#60; 0.0005, p &#60; 0.0005) and cardiac output (p = 0.043, p &#60; 0.0005, p &#60; 0.0005) were greater in pregnant women in all physiological states (respectively for the supine position, light exercise and metronomic breathing state), whilst stroke volume was lower in pregnancy only during the supine position (p &#60; 0.0005). QTe (Q wave onset to T wave end) and QTa (T wave apex) were significantly shortened (p &#60; 0.05) and QTeVI and QTaVI were increased in pregnancy in all physiological states (p &#60; 0.0005). QT variability (p &#60; 0.002) was greater in pregnant women during the supine position, whilst heart rate variability was reduced in pregnancy in all states (p &#60; 0.0005).Early pregnancy is associated with substantial changes in heart rate variability, reflecting a reduction in parasympathetic tone and an increase in sympathetic activity. QTVI shifted to a less favourable value, reflecting a greater than normal amount of QT variability. QTVI appears to be a useful method for quantifying changes in QT variability relative to RR (or heart rate) variability, being sensitive not only to physiological state but also to gestational age. We support the use of non-invasive markers of cardiac electrical variability to evaluate the risk of arrhythmic events in pregnancy, and we recommend the use of multiple physiological states during the assessment protocol. Journal Article Physiological Measurement 36 3 531 545 0967-3334 1361-6579 18 2 2015 2015-02-18 10.1088/0967-3334/36/3/531 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2018-05-01T08:26:28.5486329 2015-05-11T08:38:23.5945765 Faculty of Science and Engineering School of Engineering and Applied Sciences - Uncategorised R E Carpenter 1 L A D’Silva 2 S J Emery 3 O Uzun 4 D Rassi 5 M J Lewis 6 Dareyoush Rassi 7 Michael Lewis 8 0021301-22102015103744.pdf Carpenter2015v2.pdf 2015-10-22T10:37:44.1630000 Output 915905 application/pdf Accepted Manuscript true 2015-10-22T00:00:00.0000000 false
title Changes in heart rate variability and QT variability during the first trimester of pregnancy
spellingShingle Changes in heart rate variability and QT variability during the first trimester of pregnancy
Dareyoush Rassi
Michael Lewis
title_short Changes in heart rate variability and QT variability during the first trimester of pregnancy
title_full Changes in heart rate variability and QT variability during the first trimester of pregnancy
title_fullStr Changes in heart rate variability and QT variability during the first trimester of pregnancy
title_full_unstemmed Changes in heart rate variability and QT variability during the first trimester of pregnancy
title_sort Changes in heart rate variability and QT variability during the first trimester of pregnancy
author_id_str_mv 51c422f16640bfafd521eb6e1395265d
b59c8f5c056bac7e6995385f22ad1639
author_id_fullname_str_mv 51c422f16640bfafd521eb6e1395265d_***_Dareyoush Rassi
b59c8f5c056bac7e6995385f22ad1639_***_Michael Lewis
author Dareyoush Rassi
Michael Lewis
author2 R E Carpenter
L A D’Silva
S J Emery
O Uzun
D Rassi
M J Lewis
Dareyoush Rassi
Michael Lewis
format Journal article
container_title Physiological Measurement
container_volume 36
container_issue 3
container_start_page 531
publishDate 2015
institution Swansea University
issn 0967-3334
1361-6579
doi_str_mv 10.1088/0967-3334/36/3/531
college_str Faculty of Science and Engineering
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hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Uncategorised{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Uncategorised
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description The risk of new-onset arrhythmia during pregnancy is high, presumably relating to changes in both haemodynamic and cardiac autonomic function. The ability to non-invasively assess an individual's risk of developing arrhythmia during pregnancy would therefore be clinically significant. We aimed to quantify electrocardiographic temporal characteristics during the first trimester of pregnancy and to compare these with non-pregnant controls.Ninety-nine pregnant women and sixty-three non-pregnant women underwent non-invasive cardiovascular and haemodynamic assessment during a protocol consisting of various physiological states (postural manoeurvres, light exercise and metronomic breathing). Variables measured included stroke volume, cardiac output, heart rate, heart rate variability, QT and QT variability and QTVI (a measure of the variability of QT relative to that of RR).Heart rate (p &#60; 0.0005, p &#60; 0.0005, p &#60; 0.0005) and cardiac output (p = 0.043, p &#60; 0.0005, p &#60; 0.0005) were greater in pregnant women in all physiological states (respectively for the supine position, light exercise and metronomic breathing state), whilst stroke volume was lower in pregnancy only during the supine position (p &#60; 0.0005). QTe (Q wave onset to T wave end) and QTa (T wave apex) were significantly shortened (p &#60; 0.05) and QTeVI and QTaVI were increased in pregnancy in all physiological states (p &#60; 0.0005). QT variability (p &#60; 0.002) was greater in pregnant women during the supine position, whilst heart rate variability was reduced in pregnancy in all states (p &#60; 0.0005).Early pregnancy is associated with substantial changes in heart rate variability, reflecting a reduction in parasympathetic tone and an increase in sympathetic activity. QTVI shifted to a less favourable value, reflecting a greater than normal amount of QT variability. QTVI appears to be a useful method for quantifying changes in QT variability relative to RR (or heart rate) variability, being sensitive not only to physiological state but also to gestational age. We support the use of non-invasive markers of cardiac electrical variability to evaluate the risk of arrhythmic events in pregnancy, and we recommend the use of multiple physiological states during the assessment protocol.
published_date 2015-02-18T03:25:14Z
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