Ventricular arrhythmias late after aortic and/or mitral valve replacement.

Since it is not yet known whether ventricular arrhythmias in patients with valve replacement are associated with an increased risk of sudden death, as in patients with coronary artery disease, a total of 46 patients who were long-term survivors of aortic and/or mitral valve replacement were examined with 24-hour ambulatory electrocardiographic monitoring, and the factors influencing the occurrence of ventricular arrhythmias were analyzed. The significance of ventricular arrhythmias in the prognosis of valve replacement is discussed. The occurrence of ventricular arrhythmias was significantly higher: 1) in patients with aortic stenosis than in those with aortic regurgitation, 2) in patients with multiple valve surgery than in those with single valve replacement and 3) in patients with larger heart size. Pre- and postoperative hemodynamics, including left ventricular function, were not significantly related to the incidence of ventricular arrhythmias. A review of the patients who died suddenly, late after valve replacement suggests that frequent ventricular arrhythmias and thromboembolism are the most important factors in the late mortality of these patients. The prognostic significance of postoperative ventricular arrhythmias in patients with valve replacement requires additional study.