The Value of the Atrial Electrokymogram in the Diagnosis of Mitral Regurgitation

Publisher Website
Google Scholar
Abstract
Electrokymograms (EKY) of the left atrium were taken in 5 normal subjects and in 15 patients with rheumatic mitral valvular disease, 10 of whom were re-examined after mitral valvuloplasty. The need for precise technique, accurate timing of the cardiac cycle, and multiple atrial tracings was emphasized. Some abnormal atrial tracings were seen in all patients with rheumatic mitral disease, none in the healthy control subjects. With the surgeon''s observation of a regurgitant jet during cardiotomy accepted as a base for comparison, the EKY diagnosis of absence, presence or degree of mitral regurgitation showed a fair consistency. This was almost complete in patients with normal sinus rhythm, while in those with atrial fibrillation the EKY tended to slightly "overdiagnose" mitral regurgitation. In no instance, however, was mitral regurgitation found to be of higher degree at operation than was predicted by EKY. After mitral valvuloplasty, the atrial EKY became normal in 5 patients, 4 of whom showed EKY evidence of regurgitation preoperatively. The tracings remained unchanged in 4, and suggested mild mitral regurgitation in one. It is concluded that with careful technique atrial EKY may be a valuable adjunct to the preoperative evaluation of the degree of mitral regurgitation in patients with rheumatic mitral disease.

This publication has 1 reference indexed in Scilit: