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European Heart Journal 1987 8(2):164-170;
Copyright © 1987 by the European Society of Cardiology.
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© 1987 The European Society of Cardiology

Holter monitoring in patients with mitral stenosis and sinus rhythm

D. R. Ramsdale, N. Arumugam, S. S. Singh, J. Pearson and R. G. Charles

Regional Adult Cardiothoracic Unit, Broadgreen Hospital Liverpool L14 3LB, England, U.K.

Received 17 April 1986; revised 1 July 1986; .

Address for reprints. Dr D. Ramsdale, Regional Adult Cardiothoracic Unit, Broadgreen Hospital, Thomas Drive, Liverpool L14 3LB, U.K.

Abstract

To determine the type and frequency of supraventricular arrhythmias in patients with mitral stenosis and sinus rhythm we studied 63 such patients, mean (sd) age 48.8 (8.2) years, by 24 hour ambulatory ECG monitoring. Thirty-five patients (55.6%) had supraventricular tachyarrhythmias. Twenty-five (39.7%) had paroxysmal atrial tachycardia, 14 (22.2%) atrial fibrillation, 8 (12.7%) multifocal atrial tachycardia and 5 atrial flutter. Ninety-five per cent (101) of episodes were asymptomatic and 96% non-sustained. Supraventricular premature beats occurred in 59 patients with couplets and triplets in 40 (63.5%) and 28 (44.4%), respectively. Frequent supraventricular premature beats, couplets, triplets and episodes of paroxysmal arrhythmias were commoner in patients > 50 years. Ectopic atrial rhythms with varying P wave morphology occurred in 12 patients (19%). Nine patients (14.3%) had suffered systemic embolic episodes. We conclude that supraventricular ectopic and tachyarrhythmias occur frequently in patients with mitral stenosis and sinus rhythm and that most paroxysms are non-sustained and asymptomatic.

Key Words: Mitral stenosis • paroxysmal supraventricular arrhythmias • Holter monitoring.


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