Atrial Arrhythmias in Cases With Mitral Stenosis and Sinus Rhythm

To determine the type and frequency of atrial arrhythmias in patients with mitral stenosis and sinus rhythm we studied 60 such patients by 48-hour ambulatory ECG monitoring. Thirty-six patients (60 %) showed arrhythmia. Twenty-eight patients (47 %) had paroxysmal atrial tachycardia, 15 (25 %) atrial fibrillation, 6 (10 %) multifocal atrial tachycardia and 4 (7 %) atrial flutter. Ninety-one per cent of episodes were asymptomatic. It is concluded that atrial arrhythmias occur frequently in patients with mitral stenosis and sinus rhythm and that most are asymptomatic. In these cases, the role of such arrhythmias in the mechanism of embolic process is open to discussion.