Arrhythmias
Palpitation is a common symptom during pregnancy, and it is often due to atrial and ventricular
ectopics. Sustained symptoms or associated symptoms of dizziness, breathlessness, chest pain or pre-
590 Y. Emmanuel, S.A. Thorne / Best Practice & Research Clinical Obstetrics and Gynaecology 29 (2015) 579e597
syncope suggest a tachyarrhythmia, and they should be investigated promptly. Both ectopics and
tachyarrhythmias are more common during pregnancy because of the increased circulating plasma
volume and associated atrial stretch. Atrial and ventricular ectopics are benign, and they require no
treatment; however, a very high burden of ventricular ectopics on ambulatory ECG monitoring may be
an early indication of impaired ventricular function, and therefore these patients should have an
echocardiogram and be followed up closely.