Screening of High Risk Patients with Mitral Valve Prolapse – Role of Heart Rate Variability

Abstract

Objective: To screen out patients with Mitral Valve Prolapse at high risk of ventricular arrhythmogenesis, based upon Heart Rate Variability. Place and Duration of Study: Department of Cardiac Electrophysiology Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi from May 2007 to March 2008. Materials and Methods: This cross sectional study included 37 patients with mitral valve prolapse. Patients with acute or old myocardial infarction, diabetes mellitus, ischemic heart disease and systemic hypertension were excluded. Patients were holtered for 24 hours and time domain analysis of heart rate variability was carried out. Statistical time domain measures of heart rate variability i.e. SDNN, SDANN and RMSSD were calculated.Descriptive statistics were used to calculate frequencies andpercentages of categorical variables using SPSS version 22. Results: Mean values of SDNN, SDANN and RMSSD were 141.62 ± 30.80, 125.16 ± 25.58 and 28.40 ± 8.06 milliseconds respectively. Two patients (5.40%) had reduced HRV in all the three indices. In one patient (2.70%) values of SDNN and SDANN were reduced whereas in another one patient (2.70%) the values of SDNN and RMSSD were reduced. In remaining one patient only SDNN was found to be reduced. Conclusion: There is a subset of patients with mitral valve prolapse with reduced heart rate variability which may be at risk of ventricular arrhythmogenesis.

Keywords

• heart rate variability, mitral valve prolapse, arrhythmogenesis, holter monitorin.