Cardiac rhythm disturbances during balloon mitral valvuloplasty, their prevention and treatment

Cardiac rhythm disturbances which developed during balloon mitral valvuloplasty were studied in 175 patients with mitral stenosis. Potassium (1,5 - 2 g) was infused during the study and in 1/3 of procedures intravenous bolus of lidocaine (average dose 100 mg) was also given. Cardiac rhythm disturbances were represented mainly by paroxysms of ventricular tachycardia and ventricular premature hearts. Supraventricular tachycardias and premature beats occurred less frequently. Duration of a rhythm disturbance varied from 2 - 3 sec to 1,5 - 2 min. Arrhythmic attacks were accompanied by fall of blood pressure, anginal pain, weakness. Patients with larger lidocaine dose (100 mg iv. bolus + 200 - 400 mg infusion throughout the procedure) had shorter duration of an arrhythmia (2 - 20 sec).