Malignant bileaflet mitral valve prolapse syndrome in patients with otherwise idiopathic out-of-hospital cardiac arrest.

摘要: Objectives The aim of this study was to investigate the prevalence mitral valve prolapse (MVP) and its association with ventricular arrhythmias in a cohort “unexplained” out-of-hospital cardiac arrest. Background Ventricular are an important cause sudden unexpected death young. role MVP remains controversial. Methods Of 1,200 patients evaluated between July 2000 December 2009 Mayo Clinic’s Long QT Syndrome/Genetic Heart Rhythm Clinic, all 24 (16 women, median age 33.5 years) idiopathic arrest (i.e., negative for ischemia, cardiomyopathy, channelopathy) were reviewed. Results All had implantable cardioverter-defibrillators (ICDs). Out-of-hospital sentinel event 22 (92%). Bileaflet found 10 (42%). Compared normal valves, bileaflet MVP: 1) over-represented by women (9 [90%] vs. 7 14 [50%], p = 0.04); 2) higher biphasic or inverted T waves (7 9 [77.8%] 4 [29%], 3) on Holter interrogation bigeminy [100%] 1 [10%], p  Conclusions authors describe “malignant” subset who experienced life-threatening arrhythmias. This phenotype is characterized MVP, female sex, frequent complex ectopic activity, including premature contractions outflow tract alternating papillary muscle fascicular origin.