P5440Mitral annulus disjunction is associated with severe ventricular arrhythmias independently of mitral valve prolapse

Background: Mitral valve prolapse (MVP) has been associated with sudden cardiac death. Mitral annulus disjunction (MAD) is an abnormal atrial displacement of the mitral valve leaflet hinge point, and has been proposed as a marker for sudden cardiac death in MVP patients. However, risk of ventricular arrhythmias in MAD itself, and in the absence of MVP, is poorly described. Purpose: To describe the clinical presentation and prevalence of severe ventricular arrhythmias in patients with MAD with and without MVP. Methods: We included consecutive patients from two hospitals with MAD defined as disjunction of >1 mm by study echocardiogram. We performed clinical examination and evaluated medical records for previous history of severe arrhythmic events, defined as aborted cardiac arrest or sustained ventricular tachycardia. Patients were excluded if they had non-mitral valvular disease, cardiomyopathies, channelopathies or obstructive coronary artery disease. We recorded the presence of MVP, measured MAD in the posterolateral wall (figure) in parasternal long-axis view, and measured left ventricular ejection fraction (EF).