Key result
Cardiac arrest from arrhythmic MVP is linked to rapidly worsening mitral regurgitation in survivors.
Case Report (n=7)
Patients surviving cardiac arrest due to arrhythmic mitral valve prolapse frequently develop rapidly worsening mitral regurgitation, which may provide insight into the arrhythmogenic substrate.
May warrant serial imaging in arrhythmic mitral valve prolapse after arrest; hypothesis-generating and should not change practice without prospective data.
BACKGROUND: Mitral valve prolapse (MVP) is the most common valvular heart disease and historically was considered benign in the absence of severe mitral regurgitation and normal left ventricular function. However, an emerging subset associated with sudden cardiac death that does not follow traditional risk stratification has been established termed the arrhythmic mitral valve prolapse (A-MVP) syndrome. This cohort provide a clinical challenge on identifying those at risk of lethal arrhythmias who may benefit from a primary prevention implantable cardiac defibrillator. CASE SUMMARY: We present 7 cases in which patients have survived cardiac arrest due to A-MVP, with the aim of further describing phenotypic characteristics that define this syndrome. DISCUSSION: We observed that after arrest, a high proportion of patients developed rapidly worsening mitral regurgitation. This observed link may provide insight into the underlying substrate of arrhythmogenesis.
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Ghelani et al. (2025) conducted a case report in Arrhythmic mitral valve prolapse (A-MVP) (n=7). Cardiac arrest due to A-MVP was evaluated on Development of rapidly worsening mitral regurgitation. Cardiac arrest due to arrhythmic mitral valve prolapse was followed by rapidly worsening mitral regurgitation in a high proportion of the 7 observed survivor cases.
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