Palpitations in midlife women: the Menopause Racing Heart Pilot Study

Although palpitations are common in midlife women and may have long-term effects on cardiovascular health and longevity, little is known about underlying electrocardiogram findings, real-time palpitations reporting, or correlates. This hypothesis-generating pilot study compared midlife perimenopausal and postmenopausal women with and without palpitations on electrocardiogram findings, real-time palpitations reporting, and potential correlates.

In this prospective, longitudinal, descriptive, comparative pilot study, 15 midlife women with and 15 without palpitations provided data. They wore an ambulatory electrocardiogram patch for 14-28 days, prospectively recorded palpitations via event button presses and daily diaries, recorded vasomotor symptoms in daily diaries, provided blood samples, and completed questionnaires.

There were no group differences in age [Md (IQR) = 56 (50, 59) vs. 55 (53, 57) with an age range of 46 to 62 in both groups] or menopausal status. The palpitations group had significantly lower heart rate variability and longer runs of atrial tachycardia. Button press data indicated that 50% of the palpitations group experienced palpitations (1) one third or more of all nights on the study, (2) nearly half of all days on the study, or (3) once or more per 24 hours on the study. Symptoms occurred during altered rhythms and normal sinus rhythm, though the latter seemed more common at night. Palpitations reporting was not related to demographics, clinical variables, biomarkers, anxiety, or somatosensory awareness but was related to having vasomotor symptoms and diabetes.

The pilot study findings revealed some important hypothesis-generating differences that are worthy of further investigation in a larger study.