Key result
Pronounced mitral annular disjunction linked to ~3.4-fold higher odds of postoperative ventricular ectopic burden.
Why the study?
Mitral annular disjunction (MAD) is associated with ventricular arrhythmias in mitral valve prolapse, but objective postoperative ventricular arrhythmia burden in patients with and without pronounced MAD remains incompletely characterized.
Is pronounced mitral annular disjunction (≥8 mm) associated with an increased postoperative ventricular arrhythmia burden in patients undergoing mitral valve surgery for Barlow's disease?
Cohort (n=126)
No
Is pronounced mitral annular disjunction (≥8 mm) associated with an increased postoperative ventricular arrhythmia burden in patients undergoing mitral valve surgery for Barlow's disease?
Pronounced mitral annular disjunction (≥8 mm) is independently associated with a higher burden of ventricular ectopy and non-sustained ventricular tachycardia following mitral valve surgery for Barlow's disease.
pMAD may inform ventricular arrhythmia risk assessment; hypothesis-generating and requires prospective validation before practice change.
Mitral annular disjunction (MAD) has been associated with ventricular arrhythmias in mitral valve prolapse, while postoperative ventricular arrhythmia burden remains incompletely characterized. We aimed to assess objective ventricular arrhythmia burden after mitral valve surgery in patients with and without pronounced MAD (pMAD). In this retrospective single-center cohort with cross-sectional postoperative rhythm assessment, patients undergoing mitral valve surgery for Barlow’s disease between 2014 and 2023 were stratified by intraoperative transesophageal echocardiography into pMAD (≥8 mm) and non-pMAD (<8 mm). All patients were invited to structured postoperative follow-up, including 24-h Holter monitoring at variable time points after surgery. Valid recordings were available in 126 of 246 patients (51.2%; 66 pMAD, 60 non-pMAD). Patients with pMAD had a significantly higher ventricular ectopic burden than those without pMAD (median 20.1 vs. 5.5 VES/h; p = 0.005). Non-sustained ventricular tachycardia was documented exclusively in the pMAD group (15.2% vs. 0%; p = 0.001). After multivariable adjustment, pMAD remained associated with high ventricular ectopic burden (OR 3.38, 95% CI 1.32–8.64; p = 0.011). These findings identify pMAD as a marker of increased postoperative ventricular arrhythmia burden after mitral valve surgery for Barlow’s disease.
No takes yet. Share an insight, caveat, or question.
Bichler et al. (2026) conducted a cohort in Barlow's disease undergoing mitral valve surgery (n=126). Pronounced mitral annular disjunction (>=8 mm) vs. Non-pronounced mitral annular disjunction (<8 mm) was evaluated on Postoperative ventricular ectopic burden (OR 3.38, 95% CI 1.32-8.64, p=0.011). Pronounced mitral annular disjunction (>=8 mm) was associated with increased postoperative ventricular ectopic burden (median 20.1 vs 5.5 VES/h; adjusted OR 3.38; 95% CI 1.32-8.64; p=0.011).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: