[Evaluation of the activity of the heart conduction system with special reference to the sinoatrial node automatism in patients with mitral valve prolapse syndrome].

Electrophysiological examination of hearts were performed in 35 women and 25 men aged 18-63 years (mean age 38 years) without any concurrent heart diseases, divided into two groups: with PMVP (group I--40 subjects) and patients without this valvular anomaly (group II--20 subjects). In the patients with PMVP the examination revealed a significantly more frequent occurrence of the so-called "electrophysiological anomalies" (in 67.5%). The following appeared most frequently: sinus automatism disorders (32.5%), accessory a-v pathways (32.5%), longitudinal a-v node dissection (20%), and disorders of intracardiac conduction in segments: proximal (15%), distal (7.5%) and in both (5%). The implementation of pharmacological tests (with ajmalin, propranolol and atropine) made it possible to detect, in group with PMVP, the existence of occult conduction disturbances, particularly in distal segments of the conduction system (10%), and also to estimate exactly the character of the sinus node dysfunction (the background being in 7 patients functional, in 6 organic). During the programmed heart stimulation supraventricular dysrhythmias were evoked in 17 patients with PMVP. This is a proof that there is increased predisposition for paroxysmal supraventricular arrhythmias to occur in patients with mitral valve anomaly.