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Supraventricular arrhythmia in mitral valve prolapse

Predictive value of P-wave dispersion and atrial conduction time

Supraventrikuläre Arrhythmien bei Mitralklappenprolaps

Prädiktiver Wert der P-Wellen-Dispersion und der Vorhofüberleitungszeit

Herz volume 47, pages 67–72 (2022)Cite this article

Abstract

Background

The incidence of supraventricular arrhythmia (SVA) is high in patients with mitral valve prolapse (MVP). The purpose of our study was to determine the role of parameters showing atrial conduction heterogeneity such as P‑wave dispersion (PWD) and atrial electromechanical delay (AEMD) in predicting the development of SVA in MVP patients.

Methods

A total of 76 patients with MVP (56 female, 20 male) were included in the study. The patients were divided into two groups according to the presence or absence of SVA: 36 patients were allocated to the non-SVA group and 40 patients to the SVA group. Heart rate variability (HRV), PWD, and AEMD values were determined and compared.

Results

The PWD was found to be higher in the SVA group. Interatrial EMD was 32.00 ms (25.00–35.00) in patients with SVA while it was 18.00 ms in patients without SVA (11.00–23.75); the intra-atrial EMD was 17.0 ms (10.00–20.00) in patients with SVA whereas it was 10.00 ms (4.00–14.00) in patients without SVA. Lower HRV was found in the SVA group.

Conclusion

In the SVA group, PWD and AEMD were increased while HRV values were decreased. Noninvasive parameters may help predict the presence and incidence of SVA during the follow-up of this group of patients.

Zusammenfassung

Hintergrund

Die Inzidenz supraventrikulärer Arrhythmien (SVA) ist bei Patienten mit Mitralklappenprolaps (MVP) hoch. Ziel der vorliegenden Arbeit war es, für die Vorhersage der Entwicklung von SVA bei MVP-Patienten die Bedeutung von Parametern zu ermitteln, welche den Nachweis einer Heterogenität der Vorhofüberleitung liefern, z. B. die P‑Wellen-Dispersion (PWD) und die atriale elektromechanische Verzögerung (AEMD).

Methoden

Dazu wurden 76 Patienten mit MVP (56 Frauen, 20 Männer) in die Studie einbezogen. Die Patienten wurden – je nach Vorliegen von SVA oder nicht – in 2 Gruppen unterteilt: Der Non-SVA-Gruppe wurden 36 Patienten zugewiesen und der SVA-Gruppe 40 Patienten. Herzfrequenzvariabilität (HRV), PWD und AEMD-Werte wurden ermittelt und verglichen.

Ergebnisse

In der SVA-Gruppe erwies sich die PWD als höher denn in der Vergleichsgruppe. Die interatriale EMD betrug 32,00 ms (25,00–35,00) bei Patienten mit SVA, während sie 18,00 ms bei Patienten ohne SVA betrug (11,00–23,75); die intraatriale EMD lag bei 17,0 ms (10,00–20,00) bei Patienten mit SVA, dagegen bei 10,00 ms (4,00–14,00) für Patienten ohne SVA. In der SVA-Gruppe wurde eine niedrigere HRV festgestellt.

Schlussfolgerung

In der SVA-Gruppe waren PWD und AEMD erhöht, während die HRV-Werte niedriger waren. Noninvasive Parameter können möglicherweise zur Vorhersage des Vorliegens und der Inzidenz von SVA im Rahmen der Nachuntersuchung bei dieser Patientengruppe beitragen.

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Affiliations

  1. Cardiology Department, SBU Antalya Training and Research Hospital, Antalya, Turkey

    Zehra Erkal MD, Nermin Bayar MD, Associate Professor, Erkan Koklu MD, Associate Professor, Goksel Cagırcı MD, Professor & Sakir Arslan MD, Professor

  2. Emergency Medicine Department, SBU Kanuni Sultan Suleyman Training and Research Hospita, Istanbul, Turkey

    Ramazan Guven MD, Associate Professor

Authors
  1. Zehra Erkal MD
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  2. Nermin Bayar MD, Associate Professor
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  3. Erkan Koklu MD, Associate Professor
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  4. Goksel Cagırcı MD, Professor
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  5. Sakir Arslan MD, Professor
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  6. Ramazan Guven MD, Associate Professor
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Corresponding author

Correspondence to Zehra Erkal MD.

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Conflict of interest

Z. Erkal, N. Bayar, E. Koklu, G. Cagırcı, S. Arslan, and R. Guven declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case. This retrospective study was performed after consultation with the institutional ethics committee and in accordance with national legal requirements.

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Erkal, Z., Bayar, N., Koklu, E. et al. Supraventricular arrhythmia in mitral valve prolapse. Herz 47, 67–72 (2022). https://doi.org/10.1007/s00059-021-05034-1

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  • DOI: https://doi.org/10.1007/s00059-021-05034-1

Keywords

  • Heart rate
  • Electrocardiography
  • Echocardiography
  • Cardiovascular abnormalities
  • Tachycardia

Schlüsselwörter

  • Herzfrequenz
  • Elektrokardiographie
  • Echokardiographie
  • Kardiovaskuläre Anomalien
  • Tachykardie