The Deleterious Role of Tachycardia in Mitral Stenosis

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Abstract
Eleven patients with mitral stenosis and atrial fibrillation were studied during artificially induced tachycardia to determine the influence of rapid ventricular rates on hemodynamic variables. Significant elevation of pulmonary artery pressure occurred, but no increase in calculated pulmonary arterial resistance was found. Pulmonary arterial wedge pressures rose in each patient with an average increase of 7 mm Hg. Cardiac output fell at the fastest rate in each patient. These changes from rapid ventricular rates appear to account for the functional deterioration often encountered in patients with mitral stenosis with the advent of atrial fibrillation.