An irregular heartbeat, medically referred to as an arrhythmia, is common during pregnancy. Approximately 50 percent of pregnant women experience some kind of irregularity in their heart rhythm, according to Cleveland Clinic 1. Most of these cases are benign, meaning they do not require any medical intervention and do not cause harm. Some arrhythmias can cause damage to you and your developing baby, however, so if your heartbeat is irregular while pregnant, contact your doctor.
Although the exact cause of an irregular heart beat when pregnant is unclear, there are several factors that may contribute to an arrhythmia. Pregnancy changes the hormonal state of your body, increasing levels of estrogen and another hormone called β-human chorionic gonadotropin. This may affect the action of the cardiac ion channels, which allow sodium, calcium and potassium into and out of the cells to control heartbeat.
When you are pregnant, the volume of your blood increases to provide enough oxygen for both you and your developing baby. This increased blood volume puts extra stress on the heart, doubling the cardiac output and increasing the amount of diastolic beats.
- Although the exact cause of an irregular heart beat when pregnant is unclear, there are several factors that may contribute to an arrhythmia.
- This increased blood volume puts extra stress on the heart, doubling the cardiac output and increasing the amount of diastolic beats.
Caffeine & an Irregular Heartbeat
Pregnancy may cause several different types of irregular heartbeats. Palpitations are sensations that feel like your heart is racing, pounding or skipping beats 6. You may feel heart palpitations in your chest and neck 6. Supraventricular tachycardia, or SVT, is a broad term that applies to any heart beat that is faster than normal. SVT is generally considered more dangerous than palpitations, and medication may be necessary for this condition.
Atrial fibrillation, an irregular, rapid heartbeat, is possible, but rare, during pregnancy 7. Most women with atrial fibrillation during pregnancy have congenital heart disease or hyperthyroidism prior to pregnancy, according to the University Hospital of Heraklion 147.
- Pregnancy may cause several different types of irregular heartbeats.
- Palpitations are sensations that feel like your heart is racing, pounding or skipping beats 6.
Heart arrhythmias during pregnancy are treated very conservatively 2. When an arrhythmia is discovered, your doctor will test for underlying causes. If no medical cause is found, treatment generally consists of rest and procedures called vagal maneuvers, which can help slow the heart rate. Vagal maneuvers may include applying ice to the face, massaging the carotid artery and the Valsalva maneuver, which involves forceful exhalation while holding the nose and mouth shut.
If the arrhythmia causes physical symptoms or results in low blood pressure, your doctor may prescribe anti-arrhythmic medications. No anti-arrhythmic medications are considered completely safe during pregnancy, however, so they should be avoided during the first trimester, according to Cleveland Clinic 12.
- Heart arrhythmias during pregnancy are treated very conservatively 2.
- No anti-arrhythmic medications are considered completely safe during pregnancy, however, so they should be avoided during the first trimester, according to Cleveland Clinic 1.
What Is an Abnormal EKG?
If you do require anti-arrhythmic medications during pregnancy, visit your doctor for regular monitoring. Your doctor will perform ECGs and measure the level of medication in your blood to make sure the levels do not become toxic to you or your developing baby.
Caffeine & an Irregular Heartbeat
What Is an Abnormal EKG?
Causes of Palpitations and Tinnitus
What Are the Causes of Shortness of Breath in the Morning?
High or Low Potassium Levels & Bradycardia
Symptoms of Headaches With Dizziness
The Normal Pulse Rate During Pregnancy
Causes of Low Blood Pressure During Pregnancy
Abnormal Heart Beat and Shortness of Breath
What Are the Causes of Blood Clots in the Legs?
- Cleveland Clinic: Heart Disease and Pregnancy
- Cleveland Clinic: Arrhythmias and Pregnancy
- International Journal of Cardiology: Cardiac Arrhythmias in Pregnancy: Clinical and Therapeutic Considerations
- University Hospital of Heraklion: Arrhythmias in Pregnancy
- American Family Physician: Management of Common Arrhythmias: Part II. Ventricular Arrhythmias and Arrhythmias in Special Populations
- MedlinePlus: Heart Palpitations
- Mayo Clinic: Atrial Fibrillation
- Ashley EA, Niebauer J. Cardiology Explained. London: Remedica; 2004. Chapter 8, Arrhythmia.
- King GS, McGuigan JJ. Antiarrhythmic Medications. [Updated 2019 Sep 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Roden DM. Antiarrhythmic drugs: from mechanisms to clinical practice. Heart. 2000;84(3):339–346. doi:10.1136/heart.84.3.339
- Gopinathannair R, Olshansky B. Management of tachycardia. F1000Prime Rep. 2015;7:60. Published 2015 May 12. doi:10.12703/P7-60
- Wooten JM, Earnest J, Reyes J. Review of common adverse effects of selected antiarrhythmic drugs. Crit Care Nurs Q. 2000;22(4):23-38.
- Frommeyer G, Eckardt L. Drug-induced proarrhythmia: risk factors and electrophysiological mechanisms. Nat Rev Cardiol. 2016;13(1):36-47.
- Wolkove N, Baltzan M. Amiodarone pulmonary toxicity. Can Respir J. 2009;16(2):43–48. doi:10.1155/2009/282540
- Hafeez Y, Armstrong TJ. Atrioventricular Nodal Reentry Tachycardia (AVNRT) [Updated 2019 May 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Nesheiwat Z, Goyal A, Jagtap M. Atrial Fibrillation (A Fib) [Updated 2019 Jul 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Farzam K, Jan A. Beta Blockers. [Updated 2019 Jun 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- McKeever RG, Hamilton RJ. Calcium Channel Blockers. [Updated 2019 Sep 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. What are blood thinners (anti-clotting medication) and how are they used? 2013 Nov 25 [Updated 2017 Oct 5].
- Baker JG, Hill SJ, Summers RJ. Evolution of β-blockers: from anti-anginal drugs to ligand-directed signalling. Trends Pharmacol Sci. 2011;32(4):227–234. doi:10.1016/j.tips.2011.02.010
- Messerli FH, Bangalore S, Bavishi C, Rimoldi SF. Angiotensin-Converting Enzyme Inhibitors in Hypertension: To Use or Not to Use?. J Am Coll Cardiol. 2018;71(13):1474-1482.
- Kusumoto FM, Goldschlager N. Implantable cardiac arrhythmia devices--part I: pacemakers. Clin Cardiol. 2006;29(5):189-94.
- Chia PL, Foo D. Overview of implantable cardioverter defibrillator and cardiac resynchronisation therapy in heart failure management. Singapore Med J. 2016;57(7):354–359. doi:10.11622/smedj.2016117
- Dinshaw L, Schäffer B, Akbulak Ö, et al. Long-term efficacy and safety of radiofrequency catheter ablation of atrial fibrillation in patients with cardiac implantable electronic devices and transvenous leads. J Cardiovasc Electrophysiol. 2019;30(5):679-687.
- Gold DR, Catanzaro JN, Makaryus JN, et al. Electrophysiologic study: its predictive value for ventricular arrhythmias. Tex Heart Inst J. 2010;37(3):291–296.
- Bansal M, Molian VA, Maldonado JR, Aldoss O, Ochoa LA, Law IH. Cost analysis of combining congenital cardiac catheterization and electrophysiology procedures in an outpatient setting. Pacing Clin Electrophysiol. 2018;41(11):1428–1434. doi:10.1111/pace.13477
- Keçe F, Zeppenfeld K, Trines SA. The Impact of Advances in Atrial Fibrillation Ablation Devices on the Incidence and Prevention of Complications. Arrhythm Electrophysiol Rev. 2018;7(3):169–180. doi:10.15420/aer.2018.7.3
- Shah AJ, Lim HS, Yamashita S, et al. Non Invasive ECG Mapping To Guide Catheter Ablation. J Atr Fibrillation. 2014;7(3):1139. Published 2014 Oct 31. doi:10.4022/jafib.1139
- Cakulev I, Efimov IR, Waldo AL. Cardioversion: past, present, and future. Circulation. 2009;120(16):1623–1632. doi:10.1161/CIRCULATIONAHA.109.865535
- Cox JL, Churyla A, Malaisrie SC, et al. When Is a Maze Procedure a Maze Procedure?. Can J Cardiol. 2018;34(11):1482-1491.
- Bachar BJ, Manna B. Coronary Artery Bypass Graft. [Updated 2019 May 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Nalliah CJ, Sanders P, Kalman JM. The Impact of Diet and Lifestyle on Atrial Fibrillation. Curr Cardiol Rep. 2018;20(12):137.
- Skielboe AK, Bandholm TQ, Hakmann S, Mourier M, Kallemose T, Dixen U. Cardiovascular exercise and burden of arrhythmia in patients with atrial fibrillation - A randomized controlled trial. PLoS One. 2017;12(2):e0170060. Published 2017 Feb 23. doi:10.1371/journal.pone.0170060
- Nalliah CJ, Sanders P, Kottkamp H, Kalman JM. The role of obesity in atrial fibrillation. Eur Heart J. 2016;37(20):1565-72.
- D'alessandro A, Boeckelmann I, Hammwhöner M, Goette A. Nicotine, cigarette smoking and cardiac arrhythmia: an overview. Eur J Prev Cardiol. 2012;19(3):297-305.
- Albert MA. Biomarkers and heart disease. J Clin Sleep Med. 2011;7(5 Suppl):S9–S11. doi:10.5664/JCSM.1342
- Buckley U, Shivkumar K. Stress-induced cardiac arrhythmias: The heart-brain interaction. Trends Cardiovasc Med. 2016;26(1):78–80. doi:10.1016/j.tcm.2015.05.001
- Moos RH, Schutte KK, Brennan PL, Moos BS. Older adults' alcohol consumption and late-life drinking problems: a 20-year perspective. Addiction. 2009;104(8):1293–1302. doi:10.1111/j.1360-0443.2009.02604.x
- Tsai CC, Li AH, Tu CM, Hwang KL, Jeng C. Effectiveness of a Tailored Lifestyle Management Program for Middle-Aged Women With Coronary Artery Disease: A Preliminary Study. J Nurs Res. 2019;27(1):1–10. doi:10.1097/jnr.0000000000000271
- Ceylan E, Ozpolat C, Onur O, Akoglu H, Denizbasi A. Initial and Sustained Response Effects of 3 Vagal Maneuvers in Supraventricular Tachycardia: A Randomized, Clinical Trial. J Emerg Med. 2019;57(3):299-305.
- Ye Q, Xie Y, Shi J, Xu Z, Ou A, Xu N. Systematic Review on Acupuncture for Treatment of Dysphagia after Stroke. Evid Based Complement Alternat Med. 2017;2017:6421852.
- Fei Y, Fei R, Zhang J, Sun Y, Yu Q. Systematic Evaluation of Efficacy and Safety of Acupuncture Treatment for Patients with Atrial Fibrillation. Open Access Maced J Med Sci. 2019;7(3):461–466. Published 2019 Jan 26. doi:10.3889/oamjms.2019.036
- Tyagi A, Cohen M. Yoga and heart rate variability: A comprehensive review of the literature. Int J Yoga. 2016;9(2):97–113. doi:10.4103/0973-6131.183712
- American Heart Association. Medications for Arrhythmia. Updated September 2016.
- Bohnen M, Stevenson WG, Tedrow UB, et al. Incidence and Predictors of Major Complications From Contemporary Catheter Ablation to Treat Cardiac Arrhythmias. Heart Rhythm. November 2011;8(11):1661–6. doi:10.1016/j.hrthm.2011.05.017.
- Li Y, Barajas-Martinez H, Li B, et al. Comparative Effectiveness of Acupuncture and Antiarrhythmic Drugs for the Prevention of Cardiac Arrhythmias: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Physiology. 2017;8:358. doi:10.3389/fphys.2017.00358.
- Mayo Clinic Staff. Heart Arrhythmia. Mayo Clinic. Updated December 27, 2017.
- Mitchell LB. Overview of Abnormal Heart Rhythms. Merck Manual: Consumer Version.
Lindsay Boyers has a Bachelor of Science in nutrition from Framingham State College and a certificate in holistic nutrition from the American College of Healthcare Sciences. She is also a licensed aesthetician with advanced training in skincare and makeup. She plans to continue on with her education, complete a master's degree program in nutrition and, ultimately, become a registered dietitian.