Valvular & structural heart disease
Mitral Annular Substrate and Ventricular Arrhythmias in Arrhythmogenic Mitral Valve Prolapse With Mitral Annular Disjunction
Authors' conclusion
In patients with bileaflet MVP and MAD undergoing catheter ablation, the mitral valve annulus often contains low-voltage areas harboring the substrate for monomorphic VT and PVCs. Ablation in these patients was safe and improved arrhythmia control.
Study context
- Population
- Patients with bileaflet mitral valve prolapse (MVP) and mitral annular disjunction (MAD) undergoing catheter ablation for ventricular tachycardia (VT) and/or premature ventricular complexes (PVCs)8 with prior cardiac arrest
- Participants
- 18 patients
- Outcome
- Arrhythmia substrate and ablation outcomes
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
- PVCs targeted for ablation (symptomatic PVCs n = 15, PVC-induced VF n = 3)
- 18
- Sustained monomorphic VT targeted
- 7 of 18
- Low voltage at mitral annulus corresponding to VT target sites, patients with sustained VT
- 6 of 7
- Low voltage in areas of MAD
- 4 of 7
- VT patients rendered noninducible post-ablation
- 6 of 7
- PVC burden reduced from 11.0% ± 10.4% to 4.0% ± 5.5%
- P = 0.004
- VT recurrence over mean follow-up 33.9 ± 43.4 months
- 0
- Repeat ablations for VT
- 0
- Repeat ablation for PVCs
- 5 of 18
Observational data: associations, not effects.
Safety
- Major complications
- 0
Original publication
Mitral Annular Substrate and Ventricular Arrhythmias in Arrhythmogenic Mitral Valve Prolapse With Mitral Annular Disjunction. JACC Clin Electrophysiol. Published 19 April 2023. doi:10.
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