Valvular & structural heart disease
Ventricular arrhythmias during exercise in patients with mitral valve prolapse
Authors' conclusion
In patients with MVP, the occurrence of VA during exercise is associated with more advanced mitral valve abnormalities, including MAD, and with higher rates of severe arrhythmic events during follow-up. Performing an exercise test, combined with the clinical and echocardiographic assessments, may therefore offer important complementary information useful for patient management.
Study context
- Population
- Patients with mitral valve prolapse (MVP) who underwent a clinically indicated exercise testpatients with MVP, 58 (48–69) years, 53% male
- Participants
- 375 patients
- Comparison
- Severity of ventricular arrhythmias (VA) during exercise and arrhythmic events during follow-up
- no VAn = 242
- minor VAn = 88
- major VAn = 45
Main finding
As reported in the abstract
Severity of VA during exercise test
Further findings
Bileaflet prolapse and mitral annular disjunction (MAD)
- Patients with minor and major VAs showed more often bileaflet prolapse and MAD than patients with no VA
- P < 0.001
Severe arrhythmic event (sustained VA or ventricular fibrillation, ICD implantation and VA ablation) · median follow-up 101 months (IQR 58-138 months)
- Patients developing a severe arrhythmic event
- 35 patients (9%)
- Patients with major VA showed the worst arrhythmic event-free survival (Kaplan-Meier)
- log-rank p<0.001
- Left ventricular end-systolic diameter, MAD and VA severity during exercise independently associated with this outcome (multivariable analysis)
Original publication
Ventricular arrhythmias during exercise in patients with mitral valve prolapse. Heart. Published 20 October 2025. doi:10.
Summarised from the published abstract; every number is checked against it