Cardiac arrhythmias 3 months after hospitalization for COVID-19

Abstract Background The long-term frequencies of cardiac arrhythmias in hospitalized coronavirus disease 2019 (COVID-19) patients have not been thoroughly investigated. Purpose To describe the prevalence of cardiac arrhythmias, 3–4 months after hospitalization for COVID-19. Methods and results Participants with COVID-19 discharged from five large Norwegian hospitals were invited to participate in a prospective cohort study. We examined 201 participants (44% females, mean age 58.5 years) with 24-hour electrocardiogram 3–4 months after discharge. Body mass index (BMI) was 28.3±4.5 kg/m2 (mean ± SD), and obesity (BMI >30) was found in 70 participants (34%). Clinically significant arrhythmias were defined as; ventricular tachycardia (non-sustained or sustained), premature ventricular contractions (PVC) exceeding 200/24 h, or coupled PVC, atrial fibrillation/flutter, second-degree atrioventricular block (AV-block) type 2, complete AV-block, sinoatrial (SA) block exceeding 3 s, premature AV-nodal beats in bigeminy, supraventricular tachycardia (SVT) exceeding 30 s, and sinus bradycardia with less than 30 beats/min. High-sensitive cardiac troponin T (hs-cTnT) was measured at the 3-month follow-up. Results Cardiac arrhythmias were found in 27% (n=54) of the participants. Ventricular premature contractions and non-sustained ventricular tachycardia were the most common arrhythmias, found in 22% (n=44) of the participants. Premature ventricular contractions were the most frequent cardiac arrhythmia. More than 200 PVCs per day were observed in 37 participants (18%) with a mean of 1300 PVC/day, and in 35 (95%) of these participants, the PVCs were polymorphic. Among 10 patients experiencing NSVT, 5 participants had previous CVD, including coronary heart disease (n=1), 1 atrial fibrillation, 2 venous thromboembolism, 4 heart failure. Atrial fibrillation was found in seven patients (3%), none of them of new-onset. SA block >3 seconds was only observed in one patient, and no incidence of high degree AV block was discovered. Pre-existing cardiovascular disease or hypertension (CVDH) were reported in 40% (n=81) of the participants. The CVDH group had an increased amount of arrhythmia compared to the group free of CVDH (p=0.04). High PVCs showed a fair correlation with hs-cTnT levels at 3 months (ρ=0.21 p=0.048). Conclusions Three months following hospital discharge with COVID-19, cardiac arrhythmia was found in every fourth participant and was associated with a higher concentration of hs-cTnT at 3 months. The clinical implications of persistent ventricular arrhythmia following COVID-19 is not clear, but ventricular ectopy has been linked to increased risk of cardiac disease, including cardiomyopathy and sudden cardiac death. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): The National Association for Heart, Lung diseases and the Norwegian Health Association and Akershus University Hospital.

Download Full-text

Non-invasive mid-term ECG monitoring for the detection of atrial fibrillation in an outpatient population

European Heart Journal ◽

10.1093/ehjci/ehaa946.0381 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J Cai ◽

K.K Yeo ◽

P Wong ◽

C.K Ching

Keyword(s):

Atrial Fibrillation ◽

Public Institution ◽

First Episode ◽

Prior History ◽

Funding Source ◽

Monitoring Device ◽

Ecg Monitoring ◽

Non Invasive ◽

Increased Risk ◽

The Mean

Abstract Background Atrial fibrillation (AF) is a common arrhythmia with significant morbidity due to an increased risk of ischemic stroke. Outpatient electrocardiogram (ECG) monitoring is an integral part of the diagnosis of AF. Conventional 24 hour Holter monitoring can be cumbersome and often fails to diagnose patients with paroxysmal AF. Spyder ECG is a non-invasive ECG monitoring device that allows wireless transmission of ECG information for analysis. It is small and comfortable, allowing for easy application for the screening and detection of AF over a mid-term duration. Purpose This study aims to evaluate the incidence of AF in patients with no prior AF and CHADsVASC score of at least 1 with the use of the Spyder ECG mid-term ECG monitoring device. Methods Patients aged 21 to 85 years old with no prior history of AF and CHADsVASC score of at least 1 were recruited from outpatient clinics of 3 large tertiary hospitals in Singapore from December 2016 to April 2019. Patients wore the Spyder ECG device for up to 2 weeks, during which continuous ECG information was uploaded onto a central cloud database and analysed. Results There were 363 patients recruited. The mean age was 61±10.0 years and 65.1% were male. There were 80.3% Chinese, 11.6% Malay, 7.5% Indian and 20.6% of other races. 68.3% of the patients were non-smokers and 74.0% of them were non-alcohol drinkers. The mean BMI of 25.5±4.7 kg/m2. The patient population had significant co-morbidities. 76.3% of the patients had hypertension, 69.4% of them had hyperlipidemia and 40.5% of them had diabetes mellitus. 10.0% of them had congestive cardiac failure and 56.7% had ischaemic heart disease. 11.3% of patients had a previous stroke and 20.4% had a prior myocardial infarction. 7.8% of the patients had asthma, 5.8% of them had thyroid disease and 9.9% of them had chronic kidney disease. They were monitored for a mean of 5.4±2.9 days each. There were 15 (4.1%) patients in whom AF was detected. The patients with AF wore the device for a mean of 5.7±2.0 SD days. The mean burden of AF was 9.0% of monitored time. 46.7% of the patients with AF had detection of AF on the first day, 26.7% on the second day, 13.3% on the third day and 13.3% on the seventh day. The mean duration of the first episode of AF was 251±325 minutes. 7 out of 15 (46.7%) of patients had first episodes of AF lasting less than 10 minutes. Conclusion Continuous mid-term ECG monitoring was able to detect AF in 15 (4.1%) of a population of 363 patients with no prior AF and CHADsVASC score of at least one, monitored for a mean of 5.4 days. Most episodes (53.3%) of AF were detected after the first day of ECG monitoring. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Duke-NUS Medical School Singapore

Download Full-text

New Onset of Atrial Fibrillation" as an Outcome Predictor in Critically Ill Patients with Sepsis: A Systemic Review

QJM ◽

10.1093/qjmed/hcab086.071 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mohamed W Mohamed ◽

Mostafa K Riyad ◽

Ahmed M Khamis ◽

Heba F Toulan

Keyword(s):

Atrial Fibrillation ◽

Critically Ill ◽

Critically Ill Patients ◽

Cardiac Arrhythmias ◽

Meta Analysis ◽

Systemic Review ◽

Common Occurrence ◽

Severity Of Disease ◽

Increased Risk ◽

New Onset

Abstract Background Evidence of various cardiac arrhythmias in septic patients has been demonstrated by multiple clinical reports and observations .Most cardiac arrhythmias in sepsis are new-onset and may be related to sepsis-induced myocardial dysfunction, autonomic dysfunction and, most likely also, by impairment and involvement of the cardiac conduction system. Aim of the Work to describe the incidence of NOAF and to determine the risk factors associated with its development, as well as its clinical course and its effect on the outcome of patients with sepsis admitted to the ICU. Patients and Methods A systematic search was conducted to retrieve articles that investigated the association of NOAF in patients diagnosed with sepsis. We identified potential Englishlanguage sources from the PubMed, Medline, and EMBASE databases. Keywords used were “atrial fibrillation” and (“sepsis” or “septic shock”). In addition, reference lists of any studies meeting inclusion criteria were reviewed manually to identify additional relevant publications. Results In our meta-analysis, we found that NOAF is a common occurrence in critically ill patients with sepsis, and its incidence rises with increasing severity of disease. Also, we found that NOAF in sepsis patients is significantly associated with increased risk of ICU. In hospital, and After hospital discharge mortality, as well as, increased risk of developing ischemic stroke. Conclusion NOAF is a common occurrence in critically ill patients with sepsis, and its incidence rises with increasing severity of disease. Our Meta-analysis suggests that it is independently associated with poor outcome. In view of these findings there is a need for better quality observational studies, because reliable identification of patients with sepsis who are prone for the development of AF may allow for early pharmacological interventions to prevent this complication.

Download Full-text

Abstract P009: Growth Differentiation Factor 15 And The Subsequent Risk Of Atrial Fibrillation: The Atherosclerosis Risk In Communities Study

Circulation ◽

10.1161/circ.143.suppl_1.p009 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Mengkun Chen ◽

Ning Ding ◽

Lena Mathews ◽

Ron C Hoogeveen ◽

Christie M Ballantyne ◽

...

Keyword(s):

Atrial Fibrillation ◽

Proportional Hazards ◽

Troponin T ◽

Cox Proportional Hazards ◽

Atherosclerosis Risk In Communities ◽

Growth Differentiation Factor 15 ◽

Differentiation Factor ◽

Cox Proportional Hazards Models ◽

Increased Risk ◽

Icd 10

Introduction: Growth differentiation factor 15 (GDF-15) is a marker of oxidative stress and inflammation and has been associated with several cardiovascular disease (CVD) phenotypes. However, conflicting results have been reported regarding the association of GDF-15 with incident atrial fibrillation (AF) in the general population. Hypotheses: Higher GDF-15 level is associated with increased risk of incident AF independent of potential confounders. Methods: In 10,101 White and Black ARIC participants (mean age 60 years and 20.9% Blacks) free of AF at baseline (1993-95), we quantified the association of GDF-15 and incident AF using three Cox proportional hazards models. GDF-15 was measured by SOMA scan assay. AF was defined by hospitalizations with AF diagnosis or death certificates (ICD-9 codes: 427.31-427.32; ICD-10 codes: I48.x) or AF diagnosis by ECG at subsequent ARIC visits. Results: There were 2165 cases of incident AF over a median follow-up of 20.7 years (incidence rate 12.1 cases/1,000 person-years). After adjusting for demographic characteristics and cardiovascular risk factors, log GDF-15 was significantly associated with incident AF (hazard ratio 1.42 (1.25-1.63) for top vs. bottom quartile) (Model 1 in Table ). The result was robust even further adjusting for history of other CVD phenotypes and cardiac markers (Models 2 and 3 in Table ). In Model 3, quartiles of high-sensitive cardiac troponin T (hs-cTnT) did not demonstrate significant associations with incident AF. Conclusions: In community-based population, elevated GDF-15 level was independently and robustly associated with incident AF (even more strongly than troponin). These results suggest the involvement of GDF-15 in the development of AF and the potential of GDF-15 as a risk marker to identify individuals at high risk of AF.

Download Full-text

Atrial Fibrillation and Other Cardiac Arrhythmias (DRAFT)

10.1093/med/9780190612474.003.0005 ◽

2018 ◽

Author(s):

Antoine Schneider ◽

Rinaldo Bellomo

Keyword(s):

Atrial Fibrillation ◽

Ventricular Tachycardia ◽

Atrial Flutter ◽

Supraventricular Tachycardia ◽

Cardiac Arrhythmias ◽

Older Patients ◽

Hospital Setting ◽

Rapid Response Team ◽

Hospitalized Patients ◽

Response Team

Cardiac arrhythmias are common in hospitalized patients, with their incidence increasing in older patients and those with comorbidities. Cardiac arrhythmias represent a trigger for approximately 10% of rapid response team (RRT) activations. Of those, atrial fibrillation (AF) is the most commonly observed. Other common cardiac arrhythmias in the in-hospital setting include supraventricular tachycardia, atrial flutter, ventricular tachycardia, and bradycardias. Members of the RRT should be skilled in the diagnosis and management of these common arrhythmias. This chapter presents an overview of cardiac arrhythmias that RRT members are likely to encounter, discussing their incidence and significance, as well as their immediate management.

Download Full-text

Rates of Cardiac Rhythm Abnormalities in Patients with CKD and Diabetes

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.09420818 ◽

2019 ◽

Vol 14 (4) ◽

pp. 549-556 ◽

Cited By ~ 4

Author(s):

Nazem Akoum ◽

Leila R. Zelnick ◽

Ian H. de Boer ◽

Irl B. Hirsch ◽

Dace Trence ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiac Arrhythmias ◽

Ventricular Arrhythmias ◽

Cardiac Rhythm ◽

Cardiac Monitoring ◽

Premature Ventricular Contractions ◽

Mortality And Morbidity ◽

Conduction Abnormalities ◽

Patients With Diabetes ◽

New Diagnosis

Background and objectivesCardiac arrhythmias increase mortality and morbidity in CKD. We evaluated the rates of subclinical arrhythmias in a population with type 2 diabetes and patients with moderate to severe CKD who were not on dialysis.Design, setting, participants & measurementsThis is a prospective observational study, using continuous ambulatory cardiac monitors to determine the rate of atrial and ventricular arrhythmias, as well as conduction abnormalities in this group.ResultsA total of 38 patients (34% women), with mean eGFR of 38±13 ml/min per 1.73 m2, underwent ambulatory cardiac monitoring for 11.2±3.9 days. The overall mean rate of any cardiac arrhythmia was 88.8 (95% confidence interval [95% CI], 27.1 to 184.6) episodes per person-year (PY). A history of cardiovascular disease was associated with a higher rate of detected arrhythmia (rate ratio, 5.87; 95% CI, 1.37 to 25.21; P<0.001). The most common arrhythmia was atrial fibrillation, which was observed in two participants with known atrial fibrillation and was a new diagnosis in four patients (11%), none of whom experienced symptoms. Overall, atrial fibrillation episodes occurred at a rate of 37.6 (95% CI, 2.4 to 112.3) per PY. Conduction abnormalities were found in eight patients (21%), a rate of 26.5 (95% CI, 4.2 to 65.5) per PY. Rates of ventricular arrhythmias were low (14.5 per PY; 95% CI, 4.3 to 32.0) and driven by premature ventricular contractions.ConclusionsCardiac rhythm abnormalities are common in patients with diabetes with moderate to severe CKD not requiring dialysis. Rates of atrial fibrillation are high and episodes are asymptomatic. Future studies are needed to determine the role of screening and upstream therapy of cardiac arrhythmias in this group.

Download Full-text

POSSIBILITIES FOR PREDICTING OF CARDIAC ARRHYTHMIAS AND CONDUCTIVITY DISORDERS IN FORMER ATHLETES

Успехи геронтологии ◽

10.34922/ae.2020.33.1.018 ◽

2020 ◽

pp. 131-136

Author(s):

О. Б. Крысюк ◽

А. Г. Обрезан ◽

С. Ф. Задворьев ◽

А. А. Яковлев

Keyword(s):

Atrial Fibrillation ◽

Risk Factor ◽

Prospective Studies ◽

Cardiac Arrhythmias ◽

Medical Records ◽

Cardiac Rhythm ◽

Prognostic Model ◽

Premature Ventricular Contractions ◽

Former Athletes ◽

The Relationship

Для выявления характера взаимосвязи спортивного анамнеза лиц, практиковавших в прошлом интенcивные физические нагрузки, и выявленных у них нарушений ритма сердца и внутрисердечной проводимости был проведен ретроспективный анализ медицинских документов 39 мужчинветеранов спорта (средний возраст - 61,6±11,3 года, средняя длительность постспортивного периода - 23,9±17,3 года, средний стаж соревновательной деятельности - 20,1±9,9 года), имеющих установленные сердечно-сосудистые заболевания. Проведено скрининговое обследование на предмет нарушений ритма и проводимости сердца, эхокардиографическое исследование. Выявлено, что распространенность устойчивых пароксизмов фибрилляции предсердий составила 42% в совокупной выборке, увеличиваясь с повышением уровня спортивной квалификации. Желудочковые нарушения ритма высокой градации выявлены у 14% обследованных. Лишь три параметра были достоверно связаны с риском нарушений ритма у ветеранов спорта: уровень спортивной квалификации, наличие генерализованного атеросклероза (антириск-фактор), возраст. Риск нарушений ритма у ветеранов спорта на 43% определяется указанными факторами. Был предложен алгоритм скрининга нарушений ритма у ветеранов спорта на основе клинических данных. Необходимы дальнейшие проспективные наблюдения для валидации алгоритма. In order to analyze the relationship between the athletic qualiﬁcation and syndrome of cardiac rhythm and conductivity disturbances in former athletes, a retrospective analysis of medical records of 39 male former athletes with cardiovascular complaints (mean age 61,6±11,3 years, mean duration of career in sports 23,9±17,3 years, mean duration of post-athletic period 20,1±9,9 years) was carried out. The patients were screened for cardiac arrhythmias and underwent echocardiography. The overall prevalence of sustained paroxysms of atrial ﬁbrillation was 42%, increasing with the athletic qualiﬁcation. Ryan grade 4 b -5 premature ventricular contractions were found in 14% of patients. 3 parameters were found to be the independent predictors of arrhythmias in former athletes, i. e. athletic qualiﬁcation, multifocal atherosclerosis (as an anti-risk factor), and age. The coefﬁcient of determinance for the created prognostic model reached 43%. Further prospective studies are needed to validate an algorithm.

Download Full-text

Phytosterol Accumulation Results in Ventricular Arrhythmia, Impaired Cardiac Function and Death

10.21203/rs.3.rs-474251/v1 ◽

2021 ◽

Author(s):

Hongfei Ge ◽

Gongxin Liu ◽

Tracy M. Yamawaki ◽

Caroline Tao ◽

Shawn T. Alexander ◽

...

Keyword(s):

Mouse Model ◽

Cardiac Function ◽

Cardiac Arrhythmias ◽

Cardiac Fibrosis ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Pathophysiological Mechanism ◽

Premature Ventricular Contractions ◽

Increased Risk ◽

Impaired Cardiac Function

Abstract Heart failure (HF) and cardiac arrhythmias share overlapping pathological mechanisms that act cooperatively to accelerate disease pathogenesis. Cardiac fibrosis is associated with both pathological conditions. Our previous work identified a link between phytosterol accumulation and cardiac injury in a mouse model of phytosterolemia, a rare disorder characterized by elevated circulating phytosterols and increased cardiovascular disease risk. Here, we uncover a previously unknown pathological link between phytosterols and cardiac arrhythmias in the same animal model. Phytosterolemia resulted in inflammatory pathway induction, premature ventricular contractions (PVC) and ventricular tachycardia (VT). Both pharmacological and genetic inhibition of phytosterol absorption prevented the induction of both pathways. Inhibition of phytosterol absorption reduced inflammation and cardiac fibrosis, improved cardiac function, reduced the incidence of arrhythmias and increased survival in a mouse model of phytosterolemia. Collectively, this work identified a pathological mechanism whereby elevated phytosterols result in inflammation and cardiac fibrosis leading to impaired cardiac function, arrhythmias and sudden death. These phytosterolemia-associated comorbidities provide novel insight into the underlying pathophysiological mechanism that predispose these patients to increased risk of sudden cardiac death.

Download Full-text

Abstract 351: Downregulation of Connexin43 by MicroRNA-130a Results in Cardiac Arrhythmias

Circulation Research ◽

10.1161/res.113.suppl_1.a351 ◽

2013 ◽

Vol 113 (suppl_1) ◽

Author(s):

Gene Kim ◽

Appledene Osbourne ◽

Saoirse McSharry ◽

Michael Broman

Keyword(s):

Atrial Fibrillation ◽

Ventricular Tachycardia ◽

Cardiac Arrhythmias ◽

Immunofluorescent Staining ◽

Luciferase Reporter ◽

Mouse Heart ◽

Messenger Rnas ◽

Littermate Control ◽

Cx43 Expression ◽

Junction Protein

MicroRNAs (miRs) are endogenous ~22 nucleotide RNA molecules that are now recognized as critical regulators of diverse physiological and pathological processes; however, studies of miRs and arrhythmogenesis remain sparse. Connexin43 (Cx43), a major cardiac gap junction protein, is critical for maintaining normal cardiac electrical conduction. One aspect of arrhythmia pathogenesis that has elicited great interest has been changes in Cx43 expression. Computational analysis of messenger RNAs predicted Cx43 to be a target for miR-130a. We hypothesized that overexpression of miR-130a in adult cardiomyocytes would result in cardiac arrhythmias. To study this, we used an inducible (tetracycline-off) bigenic system to study miR-130a overexpression in the adult mouse heart. 12 weeks after induction of miR-130a, 100% (16/16) of transgenic mice demonstrated a loss of sinus rhythm and irregular ventricular activity suggestive of atrial fibrillation on surface electrocardiograms (ECG). Nonsustained ventricular tachycardia was also observed during ECG recordings. Atrial contractions could not be detected by pulse wave Doppler. Intracardiac electrocardiography confirmed the presence of atrial arrhythmias. Western blot analysis demonstrated a 90% reduction in Cx43 levels and immunofluorescent staining confirmed a near complete loss of Cx43 in transgenic compared to littermate control hearts (n=12). Morphology of the intercalated disc was evaluated by electron microscopy and showed a loss of gap junctions in transgenic hearts. To validate Cx43 as a direct target of miR-130a, we performed in vitro target assays in 3T3 fibroblasts, known to express miR-130a. Using a luciferase reporter fused to the 3’UTR of Cx43 compared to a control (SV40) 3’UTR, we found a 55% ± 6% reduction in luciferase activity with the Cx43 3’UTR (p<0.01, n=9). Addition of an antisense miR-130a inhibitor resulted in a dose dependent loss of inhibitory activity of the Cx43 3’UTR reporter, with no changes seen in the control vector. In conclusion, we have identified an unappreciated role of miR-130a as a direct regulator of Cx43. Overexpression of miR-130a results in the development of a variety of important cardiac arrhythmias including atrial fibrillation and ventricular tachycardia.

Download Full-text

Post Cardiovascular Surgery Atrial Fibrillation. Biomarkers Determining Prognosis

Current Medicinal Chemistry ◽

10.2174/0929867324666170727104930 ◽

2019 ◽

Vol 26 (5) ◽

pp. 916-924 ◽

Cited By ~ 3

Author(s):

Olivia Manfrini ◽

Edina Cenko ◽

Beatrice Ricci ◽

Raffaele Bugiardini

Keyword(s):

Atrial Fibrillation ◽

Clinical Practice ◽

English Language ◽

Cardiovascular Surgery ◽

Troponin T ◽

Evidence Synthesis ◽

Length Of Hospital Stay ◽

Myocardial Necrosis ◽

Matrix Remodeling ◽

Increased Risk

Background: New onset of atrial fibrillation (AF) after cardiovascular surgery is associated with increased risk of complications and length of hospital stay. Identification of patients at high risk of post-operative AF (POAF) may help to act with preventive strategies having clinical and economic relevance. Objective: The focus of this review is to summarize findings on biomarkers of myocardial fibrosis (PICP and PIIINP), profibrotic mediators (TGF-beta1), extracellular matrix remodeling (MMP-9), myocardial stretch (BNP and NTpro-BNP), inflammation (interleukins, C-reactive protein and sCD40L), and myocardial necrosis (high-sensitivity troponin T), biomarkers, that can be used in clinical practice to stratify patients at risk for POAF. Method: We searched English-language studies on MEDLINE and PubMed. Evidence synthesis was based on cohort studies, clinical trials and meta-analysis data. International clinical practice guidelines were reviewed, as well. Results: Factors such as cardiac remodelling, atrial pressure, surgery trauma, inflammation, oxidative stress, and sympathetic/parasympathetic activation have been implicated in the development of POAF. On the basis of multifactorial mechanism underlying the onset of POAF, several studies have investigated the predictive value of some serum biomarkers. To date, there are promising preliminary data on the clinical utility of PICP, PIINP, TGF-β1 and sCD40L, whereas data on NT-proBNP, BNP, CRP, IL- 6, and hs-cTnT are controversial. Conclusion: Although some studies have shown promising results, there is a need for future larger studies with longer follow-up, before applying biomarkers as tools for POAF risk-stratification into clinical practice.

Download Full-text

STUDY ON THE HEART DYSRHYTHM BY 24 HOURS ECG HOLTER IN PATIENTS WITH MITRAL STENOSIS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.6.11 ◽

2011 ◽

pp. 89-96

Author(s):

Tan Thinh Nguyen ◽

Thi Bich Thuan Le

Keyword(s):

Atrial Fibrillation ◽

Cardiac Arrhythmia ◽

Cardiac Arrhythmias ◽

Mitral Stenosis ◽

Sinus Bradycardia ◽

Inverse Correlation ◽

Common Disease ◽

Stenosis Severity ◽

Premature Beats

Objectives: Mitral stenosis is a common disease accounting for 40.3% of population of cardiovascular disease. Cardiac arrhythmia is a common complication of this disease. ECG is an important mean of diagnosing cardiac arrhythmia, especially ECG Holter. The advantage of ECG Holter had provided us with accurate parameters at various moments, both day and night, under exercise and at rest. Therefore, we conduct this research with 2 following objectives: 1. Determine the rate of cardiac arrhythmias and their classification in mitral valve disease throughout ECG Holter. 2. Find out the correlation between cardiac arrhythmia and mitral stenosis severity. Materials and methods: 45 patients (the youngest was 22, the oldest was 73 and average age: 43.84 ± 12.97) were diagnosed with affirmation mitral stenosis based on clinical features, X-ray, and echocardiography. ECG Holter then was recorded and analyzed in the terms of the rate and classification of cardiac arrhythmias. The results showed that: cardiac arrhythmias accounted for 53.33%, in which ventricular premature beats: 88.89%, atrial premature beats: 4.44%, sinus bradycardia: 6.67%, sinus tachycardia: 46.67%, sinus arrest: 11.11%, atrial fibrillation: 55.56%, supraventricular arrhythmias: 2.22%. The more severe mitral stenosis is, the more often heart dysrhythms appear: mitral stenosis severity I, II, III has the rate of heart dysrhythm of 6.67%, 15.56%, 31.10%, respectively. There was an inverse correlation between the severity of mitral stenosis and atrial fibrillation (r=-0.410, p<0.05); inverse correlation between the pulmonary artery pressure and degree of mitral stenosis (r=0,7361, p<0,05). There was a proportional correlation between the pulmonary hypertension and atrial fibrillation (r=0.43, p<0.05). Conclusion: ECG Holter is helpful in diagnosis, follow-up, prognosis of mitral stenosis. It is also valuable in detecting complications of mitral stenosis, aiding in treatment and improving patient’s quality of life.

Download Full-text