From Diagnosis to Treatment of Arrhythmic Mitral Valve Prolapse and Mitral Annular Disjunction

Mitral valve prolapse (MVP) and mitral annular disjunction (MAD) are common comorbidities that can lead to serious cardiac arrhythmias and sudden cardiac death (SCD). Arrhythmic MVP is characterized by the presence of MVP with frequent (over 5% ventricular extra beats) and/or complex ventricular arrhythmias, such as ventricular tachycardia (VT), non-sustained VT, or ventricular fibrillation in the absence of other causes of arrhythmia, e.g., post-infarction scar, recent ischemia, channelopathy, or cardiomyopathy. The mechanisms of the development of serious cardiac arrhythmias in patients with MVP and MAD are not fully understood. Arrhythmic MVP may be an indication for cardioverter defibrillator implantation. Considering the increased risk of SCD in this group of patients, the pathophysiology of this valvular dysfunction and characteristic deviations in diagnostic tests that indicate a higher risk of SCD are presented. The issue of tailored risk stratification in individual patients is crucial.