Twenty patients clinically identified as having balloon deformity of the mitral valve were studied to assess the incidence of ventricular arrhythmias. Echocardiography and phonocardiography were used to confirm the nature of the mitral valve lesion. Continuous 24-hour electrocardiograms were obtainedfrom all patients and analysed by a computer and 2 observers. One patient had ventricularfibrillation and 3 patients had ventricular tachycardia. There was a high incidence of other less severe forms of ventricular arrhythmis. Eight patients had inferolateral ST and T wave abnormality on the resting electrocardiogram, and were described as having the auscultatory-electrocardiographic variant of the balloon mntral valve syndrome. The occurrence of serious ventricular arrhythmias (ventricular fibrillation and tachycardia) was s4igficantly more frequent in this group. This raises the possibility that the resting electrocardiogram may identify those patients with balloon deformity of the mitral valve who are at risk from sudden death.
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