Ambulatory ECG monitoring was the most sensitive method, detecting premature ventricular contractions in 58% of mitral valve prolapse patients compared to 25% of normal subjects.
Case-Control (n=71)
Absolute Event Rate: 58% vs 25%
p-value: p=> 0.001
Ambulatory monitoring and maximal treadmill exercise were compared in 40 normal subjects and 31 patients with mitral prolapse. A variable arrhythmia spectrum was observed in prolapse during monitoring: premature ventricular contractions in 18 (58%), supraventricular arrhythmias in 11 (35%), and bradyarrhythmias in 9 (29%). Significantly less arrhythmias occurred in normal subjects during monitoring: 10 (25%, P > 0.001), 3 (8%, P < 0.001), 4 (10%, P < 0.05), and 2 (5%, P < 0.02), respectively. In patients with prolapse, arrhythmias occurred on resting electrocardiogram (ECG), 35% premature ventricular contractions, 6% supraventricular arrhythmias, and 10% bradyarrhythmias, and on treadmill exercise, 45%, 10%, and 3%; therefore, ambulatory monitoring was the most sensitive method of arrhythmia detection. No correlation existed between clinical features of prolapse and arrhythmias. Thus, arrhythmias occur in most patients with mitral prolapse, are not predictable by clinical characteristics, comprise a spectrum of ventricular and supraventricular tachyarrhythmias and bradyarrhythmias, and are best detected by ambulatory ECG monitoring.
DeMaria et al. (Tue,) conducted a case-control in Mitral valve prolapse syndrome (n=71). Mitral valve prolapse vs. Normal subjects was evaluated on Premature ventricular contractions during ambulatory monitoring (p=> 0.001). Ambulatory ECG monitoring was the most sensitive method, detecting premature ventricular contractions in 58% of mitral valve prolapse patients compared to 25% of normal subjects.