Pregnancy-associated idiopathic ventricular arrhythmia: Serial electrocardiographic evolution during pregnancy and postpartum

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Pregnancy-associated idiopathic ventricular arrhythmia (n=1). Intervention: Metoprolol and Sotalol. Primary outcome: Symptomatic and Holter suppression of arrhythmia.

Q: What does this research mean for the field?

Sotalol administered with serial QT monitoring can achieve complete symptomatic and Holter suppression of pregnancy-associated ventricular arrhythmias. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Sávia Bueno; Patricia de Oliveira; Walkíria Samuel Ávila; Maurício Scanavacca

doi:10.1016/j.jelectrocard.2026.154450

September 14, 2026Journal of Electrocardiology

Pregnancy-associated idiopathic ventricular arrhythmia: Serial electrocardiographic evolution during pregnancy and postpartum

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Key result

Sotalol with QT monitoring completely suppresses pregnancy-associated ventricular arrhythmias in a case report.

n=1

Why the study?

Pregnancy can trigger or exacerbate ventricular arrhythmias even in structurally normal hearts, but the electrocardiographic evolution during pregnancy and postpartum is not well characterized.

Key Points

To describe the clinical course, pharmacological response, and serial electrocardiographic evolution of pregnancy-associated idiopathic ventricular arrhythmia through gestation and postpartum.
Evaluated a 41-year-old female presenting at 22 weeks' gestation with symptomatic monomorphic ventricular arrhythmias via serial Holter and electrocardiographic monitoring.
Administered sequential pharmacological treatment with metoprolol followed by sotalol under QT interval surveillance, with follow-up off-therapy assessments at one and three months postpartum.
Baseline assessment revealed an 11% premature ventricular contraction burden and 313 nonsustained ventricular tachycardia episodes.
Metoprolol lowered arrhythmic burden without relieving symptoms, whereas sotalol achieved complete symptomatic relief and full suppression on Holter monitoring.
Ventricular arrhythmia recurred asymptomatically off therapy at one month postpartum and resolved spontaneously by three months postpartum.

Study Design

Type

Case Report (n=1)

Structured PICO

P

Population

One 41-year-old pregnant woman at 22 weeks' gestation who developed symptomatic monomorphic PVCs and frequent NSVT, followed through 3 months postpartum.

I

Intervention

Metoprolol, followed by sotalol (with serial QT monitoring), with subsequent discontinuation postpartum.

O

Outcome

Symptomatic and arrhythmic (Holter) suppression.

Sotalol effectively managed highly symptomatic pregnancy-associated ventricular arrhythmias when metoprolol failed, demonstrating the utility of antiarrhythmic titration and the dissociation between symptoms and arrhythmic burden during pregnancy.

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Implication

May support sotalol with QT monitoring for refractory pregnancy VA; leaves open efficacy in prospective studies.

Abstract

Pregnancy can trigger or exacerbate ventricular arrhythmias even in structurally normal hearts. A 41-year-old woman at 22 weeks' gestation developed symptomatic monomorphic premature ventricular contractions (PVCs) and frequent nonsustained ventricular tachycardia (NSVT), with 11% PVC burden and 313 NSVT episodes. Metoprolol reduced arrhythmic burden but not symptoms. Sotalol, introduced with serial QT monitoring, was followed by complete symptomatic and Holter suppression. One month postpartum, asymptomatic ventricular arrhythmia recurred off therapy, then resolved spontaneously by three months. Serial monitoring illustrates marked pregnancy-related variability and the potential dissociation between symptoms and arrhythmic burden.

Discussion

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Cite This Study

Bueno et al. (2026) conducted a case report in Pregnancy-associated idiopathic ventricular arrhythmia (n=1). Metoprolol and Sotalol was evaluated on Symptomatic and Holter suppression of arrhythmia. Sotalol, introduced with serial QT monitoring, resulted in complete symptomatic and Holter suppression of pregnancy-associated ventricular arrhythmias in a 41-year-old woman.

synapsesocial.com/papers/6ad1157600741cc3fba7d43c https://doi.org/10.1016/j.jelectrocard.2026.154450

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Pregnancy-associated idiopathic ventricular arrhythmia: Serial electrocardiographic evolution during pregnancy and postpartum

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Pregnancy-associated idiopathic ventricular arrhythmia: Serial electrocardiographic evolution during pregnancy and postpartum

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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