Tpeak-Tend interval predicts VT inducibility in arrhythmogenic mitral valve prolapse syndrome

BACKGROUND: Mitral valve prolapse (MVP) is commonly benign, but an arrhythmic phenotype (AMVP) with increased risk for sudden cardiac death has been described. A prolonged Tpeak-Tend interval has been association with increased arrhythmic risk in different clinical settings. The aim of this study was to investigate a possible correlation between prolonged Tpeak-Tend interval and ventricular tachycardia (VT) inducibility in MVP. METHODS AND RESULTS: Sixty-five patients fulfilling the EHRA criteria of AMVP syndrome underwent programmed ventricular stimulation between 2016 and 2024. Sustained polymorphic VT was induced in 19 patients (29.2%) and was significantly associated with prolonged Tpeak-Tend (100.5 ± 10.3 ms vs. 85.1 ± 9.9 ms, p = 0.002) and prolonged Tpeak-Tend/QTc (0.24 ± 0.03 vs. 0.2 ± 0.02, p = 0.004). CONCLUSION: Prolonged Tpeak-Tend was associated with VT inducibility in patients with AMVP syndrome, suggesting its potential value as simple ECG-based marker for risk stratification. If Tpeak-Tend also correlates with clinical outcome should be investigated in prospective studies.