ABNORMAL AMBULATORY ELECTROCARDIOGRAPHIC FINDINGS IN PATIENTS WITH THE MARFAN-SYNDROME

Objectives. The aim of this study was to assess the prevalence of card iac dysrhythmias and abnormalities of conduction and repolarization in the Marfan syndrome (MFS). Subjects and methods. Forty-five adult MFS patients (25 men) and healthy age and sex matched controls. A 24-h am bulatory electrocardiogram was recorded. Results. There was no differe nce in heart rates between the two groups. Two MFS patients had atrial fibrillation. The median number of premature atrial beats was 12/24 h in the MFS group vs. 6/24 h in the controls (P < 0.05), and the respe ctive medians of premature ventricular beats were 17/24 h vs. 1/24 h ( P < 0.001). Five patients but no healthy person had salves of greater than or equal to 3 premature ventricular complexes (P < 0.05). Ventric ular premature beats with R on T configuration were recorded in nine p atients but in none of the control subjects (P < 0.05). Both PQ and QT intervals at heart rates of 60, 80 and 100 beats min(-1) were longer in the MFS group compared with healthy persons (P < 0.005). Also ST se gment depression was seen more often in the MFS group (17/43 vs. 6/45; P < 0.05). In patients with MFS, the findings at ambulatory electroca rdiography showed no association with echocardiographically determined aortic root diameter, left atrial diameter or left ventricular diamet ers, wall thickness and systolic function. Nor did the electrocardiogr aphic findings correlate with the presence of mitral or tricuspid valv e prolapse. Conclusions. Patients with MFS have a higher prevalence of cardiac dysrhythmias than healthy persons. Likewise they have prolong ed atrio-ventricular conduction time and disturbed depolarization as s uggested by longer QT intervals and more common ST segment depression.