Impact of Percutaneous Mitral Balloon Valvuloplasty on P-Wave Dispersion in Patients with Rheumatic Mitral Stenosis

Introduction: P-wave dispersion (PWD) is a new electrocardiographic (ECG) index believed to reflect heterogeneous atrial conduction with ECG leads of different orientation. Mitral stenosis (MS) is associated with increased PWD, which are markers of atrial fibrillation (AF) risk. The aim of the present study was to assess the immediate effect of successful percutaneous mitral balloon valvuloplasty (PMBV) on these parameters. Patients and Methods: Seventy patients (98% females, aged 44 ± 12 years) with moderate or severe rheumatic MS and 60 healthy volunteers (95.7% females, aged 45 ± 11 years) as a control group were enrolled in the study. 12-Lead ECGs were recorded for each patient 1 day before PMBV to evaluate baseline maximum and minimum P-wave duration and PWD and repeated within 72 h. Results: The maximum P-wave duration (Pmax) and PWD in patients with MS were found to be significantly higher than those in the control group (p< 0.001). ECG parameters of Pmax (142 (120-170) vs. 130 (110-164), p< 0.001) and PWD [45 (30-69) vs. 35 (16-57), p< 0.001] decreased in the acute period of PMBV (p< 0.001). On the other hand, the procedure had no significant effect on minimum P-wave duration (p= 0.111). Conclusion: Our study has shown that Pmax and PWD were significantly higher in patients with MS than in healthy control subjects, and they decreased significantly after successful PMBV. Further prospective long-term studies are needed to confirm the relationship between atrial conduction velocities and development of AF in patients with MS