Shah Zeb, Tariq Ashraf, Abdul Samad Achakzai, Syed Nadeem Hassan Rizvi, Tahir Saghir, Naveed Ullah Khan.
Regression of ECG changes after successful percutaneous transmitral commissurotomy in patients with severe isolated mitral stenosis.
Pak Heart J Jan ;51(1):30-5.

Objective: To know regression of ECG changes after successful percutaneous mitral commissurotomy (PTMC) for severe isolated mitral stenosis patients. Methodology: This cross sectional study was conducted from 1st Feburary 2016 to 31 August 2016 (06 months) in National Institute of Cardiovascular Diseases, Karachi - Pakistan. All consecutive patients admitted for PTMC for severe isolated mitral stenosis were subjected to detailed transthoracic echocardiogram (TTE) and 12 leads ECG before and after procedure as per protocol. All the data were analyzed by SPSS Version 19.0. Result: Among total of 99 study population, females were 65(65.7%). Mean age was 27.44+-6.26 years. Standard 12 lead ECG showed P wave amplitude of 0.26+- 0.0491 mV pre PTMC versus 0.24+-0.036 mV post PTMC (p <0.001). P wave duration in V1/V2 (greater of these two chest leads) was 114.32msec +-11.94 msec (80-140msec) and 108.64msec +- 14.55 (80-140msec) pre and post PTMC respectively (p <0.001). R wave amplitude in V1/V2 (greater of then two) 0.2879 +-0.2031 mV vs. 0.2313+-0.1475mV pre and post PTMC respectively(p <0.001). Axis of the heart was 88.28+-19.51 degree (45-120) pre PTMC vs.84.34+-19.79 degrees (30-120) post PTMC respectively. RV hypertrophy as demonstrated by R wave in V1 plus S wave in V5 was 0.4830+- .2239 millivolt vs.0.3980+-.1823 millivolt (p <0.001) pre PTMC & post PTMC respectively. Conclusion: Successful PTMC procedure causes significant regression of quantitative ECG changes in isolated mitral stenosis patients in mid-term followup.

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