Holter monitoring in patients with mitral stenosis and sinus rhythm

Eur Heart J. 1987 Feb;8(2):164-70. doi: 10.1093/oxfordjournals.eurheartj.a062244.

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 greater than 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.

MeSH terms

  • Adult
  • Ambulatory Care
  • Anti-Arrhythmia Agents / therapeutic use
  • Atrial Fibrillation / diagnosis
  • Atrial Flutter / diagnosis
  • Cardiac Complexes, Premature / diagnosis
  • Electrocardiography / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve Stenosis / diagnosis*
  • Monitoring, Physiologic / methods*
  • Tachycardia / diagnosis*
  • Tachycardia / drug therapy
  • Tachycardia, Ectopic Atrial / diagnosis
  • Tachycardia, Supraventricular / diagnosis

Substances

  • Anti-Arrhythmia Agents