|| ISSN(online): 2589-8698 || ISSN(print): 2589-868X || International Journal of Medical and Biomedical Studies Available Online at www.ijmbs.info NLM (National Library of Medicine ID: 101738825) Index Copernicus Value 2018: 75.71 Original Research Article Volume 4, Issue 9; September: 2020; Page No. 01-05 1 | Page TO STUDY THE EFFECT OF BMV ON P WAVE DISPERSION AND SHORT TERM PROGNOSTIC IMPACT OF P WAVE DISPERSION IN PREDICTION OF CLINICAL OUTCOME AFTER PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY IN PATIENTS WITH MITRAL STENOSIS AND SINUS RHYTHM Ashish Kumar Agarwal 1 , Daulat Singh Meena 2 , Vijay Pathak 3 , Anoop Jain 4 , Rakesh Kumar Ola 5 Department of Cardiology, S M S Medical College, Jaipur (Rajasthan) Article Info: Received 03 July 2020; Accepted 08 September 2020 DOI: https://doi.org/10.32553/ijmbs.v4i9.1397 Corresponding author: Daulat Singh Meena Conflict of interest: No conflict of interest. Abstract Background: The aim of the present study was to study the effect of percutaneous balloon mitral valvuloplasty (PBMV) on P wave dispersion and to test the correlation between P-maximum and P-dispersion to right ventricular function and pulmonary artery pressure before and after PMBV. Also to study the impact of P-maximum and P-wave dispersion on the short term clinical outcome after successful PBMV in patients with mitral stenosis (MS) and sinus rhythm. Methods: 75 patients undergoing PMBV were enrolled in this study. We evaluated P-maximum, P-minimum and P-wave dispersion before and one month and one year after PBMV. We studied the changes in pulmonary arterial pressure (PAP), left atrial (LA) dimension, mitral diastolic gradient, and mitral valve area, in addition to the changes in right ventricular function utilizing tissue Doppler assessment both before and after PMBV, in addition the role of the P-wave dispersion in prediction of late cardiac events. Results: There were significant decrease in mean diastolic gradient, PAP, and LA size and significant improvement in right ventricular tissue Doppler indices after PMBV. Accompany these hemodynamic changes after PMBV. P-maximum and P- wave dispersion were found to be decreased (P < 0.001). Conclusion: Successful PBMV was associated with a decrease in Pmax and PWD. These simple electrocardiographic indices may predict the success of the procedure immediately after PBMV. The P-maximum and P-wave dispersion changes were correlated with significant impairment of right dysfunction and the degree of pulmonary artery pressure. Keywords: PBMV.PAP,LA Introduction P-wave duration (Pmax /Pmin) and P-wave dispersion (PWD) are electrocardiographic (ECG) indices that recently have received increasing attention and been examined in a broad range of clinical settings. The prolongation of intra- and inter-atrial conduction time, and inhomogeneous propagation of sinus impulses are well-known electrophysiologic characteristics of the atrium prone to fibrillate. 1,2 PWD has been associated with these characteristic changes in the atria and used for noninvasive surrogate detection of atrial electrophysiology. 1-4 It can be defined as the difference between Pmax and Pmin. Rheumatic mitral stenosis (MS) is frequently seen in developing countries and causes significant morbidity and mortality. 5 Atrial fibrillation is the most common sustained arrhythmia encountered in patients with rheumatic MS. Limited studies are available in the literature on the relation between MS and P-wave indices. First, Turhan et al. 6 evaluated the effect of PBMV on PWD in 29 patients with MS and concluded that PWD is significantly higher in patients with MS than in healthy control subjects, and it decreases significantly after PBMV both in the short and long term. Then, Guntekin et al. 7 followed 30 patients with mild to moderate MS with ECG and echocardiography and showed that Pmax and PWD increase progressively in accordance with the severity of MS. The purpose of this study was to investigate for the first time if the immediate changes in these P-wave indices could confirm a successful PBMV procedure in patients with hemodynamically significant MS. Aims and Objective  The aim of the present study was to study the effect of PBMV on P wave dispersion and to test the correlation between P-maximum and P-dispersion to right ventricular function and pulmonary artery pressure before and after PMBV.  Also to study the impact of P-maximum and P-wave dispersion on the short term clinical outcome after successful PBMV in patients with mitral stenosis (MS) and sinus rhythm. Material and Methods A total of 75 patients with mitral stenosis and fulfill the criteria needed for percutaneous mitral balloon