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Arrhythmic mitral valve prolapse: In which patients should primary prevention of sudden cardiac death be considered

Juan M Iroulart1, Rocío Blanco1, Ana L Miceli1

  • 1Cardiology Department, Hospital Italiano de Buenos Aires, Argentina.

Current Problems in Cardiology
|May 26, 2025
PubMed

Insights

Arrhythmogenic mitral valve prolapse (AMVP) carries a rare but elevated risk of sudden cardiac death (SCD). Identifying high-risk features like mitral annular disjunction is key for primary prevention strategies.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology

Background:

  • Mitral valve prolapse (MVP) is common, yet a subset develops serious complications including ventricular arrhythmias and sudden cardiac death (SCD).
  • Arrhythmogenic mitral valve prolapse (AMVP) specifically links MVP with significant ventricular arrhythmias without other identifiable causes.

Purpose of the Study:

  • To identify key variables associated with the highest arrhythmogenic risk in patients with MVP.
  • To explore primary prevention strategies aimed at mitigating sudden cardiac death (SCD) in this population.

Main Methods:

  • This review synthesizes current literature on arrhythmogenic mitral valve prolapse (AMVP).
  • It focuses on identifying specific clinical, echocardiographic, and electrocardiographic features indicative of high arrhythmic risk.

Main Results:

  • Specific risk factors for SCD in AMVP include mitral annular disjunction (MAD), bileaflet prolapse, and specific ECG abnormalities.
  • While SCD is rare (0.2-0.4% annually), the risk is notably higher than in the general population.

Conclusions:

  • AMVP necessitates a focused, multidisciplinary approach for accurate risk stratification.
  • Standardized guidelines for primary prevention of SCD in AMVP patients are critically needed, especially given the affected demographic is often young.
Keywords:
CardiacCardiac - deathMitral valve prolapse - arrhythmiasSudden

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