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Arrhythmic complications of mitral valve prolapse

INTRODUCTION

Mitral valve prolapse (MVP) is the most common cause of primary mitral regurgitation (MR) in developed countries. The diagnosis is usually suspected from cardiac auscultation and then confirmed by echocardiography. (See "Definition and diagnosis of mitral valve prolapse".)

Although the correlation between certain nonspecific symptoms and MVP remains unclear, many patients with this disorder present with palpitations and atrial or ventricular arrhythmias [1-5]. Some studies suggest that these patients are at increased risk of sudden cardiac death (SCD) compared with the general population, but the exact incidence is unknown. Furthermore, since atrial and ventricular arrhythmias are common in the general population, it is not clearly established that the incidence of arrhythmias and SCD are in fact increased in patients with MVP.

This topic will review the incidence of arrhythmias, the risk of SCD, the electrocardiographic abnormalities that can be seen, and the treatment of arrhythmias in patients with MVP. The nonarrhythmic complications of MVP, including nonspecific symptoms and major complications, such as infective endocarditis, MR, transient ischemic attacks, and cerebrovascular accidents, are discussed separately. (See "Nonarrhythmic complications of mitral valve prolapse" and "Mitral valve prolapse syndrome".)

PREVALENCE OF ARRHYTHMIAS

Several studies report a broad range in incidence of the arrhythmias in patients with mitral valve prolapse [1-5]:

  • Atrial premature beats — 35 to 90 percent
  • Paroxysmal supraventricular tachycardia — 3 to 32 percent
  • Ventricular premature beats — 58 to 89 percent
  • Complex ventricular ectopy — 30 to 56 percent

               

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Literature review current through: May 2013. | This topic last updated: Jan 4, 2013.
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