Evaluation of electrocardiographic findings and heart rate variability findings in 24-hour rhythm holter in children with mitral valve prolapse

Purpose: Mitral valve prolapse is defined as the collapse of one or both of the mitral valve leaflets into the left atrium during left ventricular contraction. In recent studies, it has been determined that the current frequency of mitral valve prolapse in childhood varies between 2-5%. Mitral valve prolapse in children is mostly benign and survival has been found to be similar to healthy individuals. However, in some patients, complications such as mitral regurgitation, infective endocarditis, thromboembolic events, arrhythmias, chordae tendinea rupture, heart failure, cardiac sudden death, etc. may also occur. In our study, measurements of heart ratevariability in children with mitral valve prolapse, presence of ventricular rhythm disturbance and presence of mitral regurgitation were evaluated. The effect of mitral regurgitation on heart rate variability measurements was tried to be determined. Material and method: This research was conducted with total 80 patients aged 7-17 years who applied to Tekirdağ Namık Kemal University Medical Faculty Pediatric Cardiology Outpatient Clinic between January 2022 and July 2022. 30 patient who applied with the complaint of murmur but no pathology was detected and 50 patients who diagnosed with mitral valve prolapse were included in this study. The obtained data were evaluated retrospectively. In our study, patient's complaints at admission, cardiac and physical examination findings electrocardiographic findings, echocardiographic findings and 24-hour rhythm Holter findings were evaluated. Results: The mean age of the patients was 11.04±2.81 years and the mean age of the control group was 10.80±3.14 years (p>0.05). Thirty (60%) of the patients were female, 20 (40%) were male and 19 (63%) of the control group were female and 11 (37%) were male (p>0.05). There was no statistically significant difference between the echocardiographic features of the patient and control groups (p>0.05). In the 24-hour rhythm Holter examination, rare ventricular extra beats (<1%) in 10 patients, mild ventricular extra beat in 2 patients (between 1-10%), rare atrial premature beat in 4 patients, and 2nd degree atrioventricular block in 1 patient were detected. Although heart rate variability was found decreased in patients with mitral valve prolapse compared to the control group, no statistically significant difference was found. In the patient group, 30 patients had minimal mitral regurgitation (60%), 13 patients had mild to moderate mitral regurgitation (26%), and 7 patients had moderate to severe mitral regurgitation (14%). When analyzed in terms of heart rate variability, although it was observed that heart rate variability decreased as the degree of mitral regurgitation increased, there was no statistically significant difference (p>0.05). Conclusion: Heart rate variability was found decreased in patients with mitral valve prolapse compared to the control group and although heart rate variability was found decreased as the degree of mitral regurgitation increases in patients, no statistically significant difference was found