[Ventricular arrhythmias in patients with aortic valve disease (author's transl)]

In order to investigate the incidence of severe ventricular arrhythmias, the 24-h ambulatory ECG of 55 patients with aortic valve disease (NYHA classes I-IV; stenosis: n = 24; regurgitation: n = 18; mixed lesions: n = 13) without coronary heart disease were evaluated with regard to the number of premature ventricular beats and according to the Lown classification. Ventricular arrhythmias were found in 73% of all patients (Lown classes III-V: 38%; Lown classes IV-V: 20%). A significant relation between the degree of arrhythmias and the gradient or severity of regurgitation of the aortic valve could not be established. However, there was a significant linear correlation between the left ventricular ejection fraction and the degree of arrhythmias (stenosis: r = 0.60; regurgitation: r = -0.72; mixed lesions: r = 0.78; all p less than 0.005). Complex arrhythmias of Lown classes III-IV are rare (less than 10%) in patients with good left ventricular function (LVEF greater than 60%). There was a history of palpitations in 81% of patients with Lown classes III-V. According to these data, ventricular arrhythmias are present in a large number of patients with aortic valve disease. The degree of arrhythmia does not correlate to the transvalvular stenosis or the severity of regurgitation, but is strongly influenced by the myocardial performance. Therefore in patients with aortic valve disease significant arrhythmias are frequently a sign of impaired LV function.