Implantable cardioverter-defibrillators for secondary prevention in AMVP patients delivered appropriate therapies at a pooled incidence of 8.1 per 100 person-years (95% CI 5.6-10.5).
Meta-Analysis (n=166)
What is the incidence and type of recurrent ventricular arrhythmia in patients with arrhythmic mitral valve prolapse and an ICD for secondary prevention?
Patients with arrhythmic mitral valve prolapse and an ICD for secondary prevention have a high rate of recurrent ventricular arrhythmias (8.1 per 100 person-years), predominantly presenting as polymorphic VT or VF requiring shock therapy.
Abstract Background Mitral valve prolapse (MVP) is a common valvular disorder associated with ventricular arrhythmias (VAs) in a subgroup of patients, known as arrhythmic MVP (AMVP). AMVP patients with malignant VAs typically receive an implantable cardioverter-defibrillator (ICD) for secondary prevention. However, data regarding the incidence of appropriate ICD therapy and the type of arrhythmia recurrence in this population remain scarce. Objectives This study aimed to evaluate the incidence of appropriate ICD therapies and type of arrythmia recurrence in AMVP patients with an ICD implanted for secondary prevention. Methods A systematic literature search was conducted in PubMed/MEDLINE and EMBASE databases until January 2025. Studies reporting the incidence of appropriate ICD therapy in AMVP patients were included. Results A total of 9 studies met the inclusion criteria, resulting in 166 AMVP patients with ICDs for secondary prevention. The mean age was 41.8 years, with 55.8% of patients being female. Over a weighted mean follow-up of 4.9±3.1 years, 34.9% (95%CI: 28.1-42.5) of the patients experienced recurrence of VA. The pooled incidence of appropriate ICD therapies during follow-up was 8.1 per 100 person-year (95% CI: 5.6–10.5, I2: 11.7%). Regarding the type of arrhythmic recurrence, the majority of arrhythmias (53.8%, 95% CI: 44.3%–63.0%) were in the form of ventricular fibrillation or polymorphic ventricular tachycardia (VT), while the remaining arrhythmias were reported as monomorphic VT. Among 67 ventricular arrhythmic episodes reported in 7 studies with available data, 65 required shock therapy, corresponding to a shock proportion of 97.0% (95% CI: 89.6–99.6%). Conclusion AMVP patients with ICDs for secondary prevention exhibit a high risk of recurrent arrhythmias, with recurrences in the form of polymorphic VA occurring in more than half of the cases.
Kneizeh et al. (Sun,) conducted a meta-analysis in Arrhythmic Mitral Valve Prolapse (AMVP) (n=166). Implantable cardioverter-defibrillator (ICD) was evaluated on Incidence of appropriate ICD therapies (95% CI 5.6-10.5). Implantable cardioverter-defibrillators for secondary prevention in AMVP patients delivered appropriate therapies at a pooled incidence of 8.1 per 100 person-years (95% CI 5.6-10.5).