Clinical case of successful treatment of focal ventricular arrhythmia in a patient with arrhythmogenic mitral valve prolapse

Abstract

The problem of managing of patients with mitral valve prolapse and ventricular arrhythmias — arrhythmogenic mitral valve prolapse — is quite relevant in routine clinical practice, which led to the creation in 2022 of an expert consensuses on the management of such patients. Based on the criteria, it is possible to identify a group of people at high risk of sudden cardiac death and implement measures to prevent death. How to manage patients at moderate risk of sudden cardiac death remains unclear. A clinical case of successful treatment of ventricular arrhythmias in a patient with arrhythmogenic mitral valve prolapse is presented.

Keywords

arrhythmic mitral valve prolapse / ventricular arrhythmias

References

[1] Avierinos JF, Gersh BJ, Melton LJ, 3rd, et al. Natural history of asymptomatic mitral valve prolapse in the community. Circulation. 2002;106(11):1355–1361. doi: 10.1161/01.cir.0000028933.34260.09

[2] Avierinos J.F., Gersh B.J., Melton L.J. 3rd, et al. Natural history of asymptomatic mitral valve prolapse in the community // Circulation. 2002. Vol. 106, N. 11. P. 1355–1361. doi: 10.1161/01.cir.0000028933.34260.09

[3] Avierinos JF, Gersh BJ, Melton LJ, 3rd, et al. Natural history of asymptomatic mitral valve prolapse in the community. Circulation. 2002;106(11):1355–1361. doi: 10.1161/01.cir.0000028933.34260.09

[4] Freed LA, Benjamin EJ, Levy D, et al. Mitral valve prolapse in the general population: The benign nature of echocardiographic features in the Framingham Heart Study. J Am Coll Cardiol. 2002;40(7): 1298–1304. doi: 10.1016/s0735-1097(02)02161-7

[5] Freed L.A., Benjamin E.J., Levy D., et al. Mitral valve prolapse in the general population: The benign nature of echocardiographic features in the Framingham Heart Study // J Am Coll Cardiol. 2002. Vol 40, N 7. P. 1298–1304. doi: 10.1016/s0735-1097(02)02161-7

[6] Freed LA, Benjamin EJ, Levy D, et al. Mitral valve prolapse in the general population: The benign nature of echocardiographic features in the Framingham Heart Study. J Am Coll Cardiol. 2002;40(7): 1298–1304. doi: 10.1016/s0735-1097(02)02161-7

[7] Shirobokikh OE, Bylova NA. Mitral valve prolapse and sudden cardiac death: who is in the risk group? The Russian Archives of Internal Medicine. 2016;6(3):25–29. EDN: VZTUIB doi: 10.20514/2226-6704-2016-6-3-25-29

[8] Широбоких О.Е., Былова Н.А. Пролапс митрального клапана и внезапная сердечная смерть: кто в группе риска? // Архивъ внутренней медицины. 2016. Т. 6, № 3. С. 25–29. EDN: VZTUIB doi: 10.20514/2226-6704-2016-6-3-25-29

[9] Shirobokikh OE, Bylova NA. Mitral valve prolapse and sudden cardiac death: who is in the risk group? The Russian Archives of Internal Medicine. 2016;6(3):25–29. EDN: VZTUIB doi: 10.20514/2226-6704-2016-6-3-25-29

[10] Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: executive summary: a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. Circulation. 2021;143(5):35–71. doi: 10.1161/CIR.0000000000000932

[11] Otto C.M., Nishimura R.A., Bonow R.O., et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: executive summary: a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines // Circulation. 2021. Vol. 143, N 5. P. 35–71. doi: 10.1161/CIR.0000000000000932

[12] Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: executive summary: a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. Circulation. 2021;143(5):35–71. doi: 10.1161/CIR.0000000000000932

[13] Myslitskaya GV, Novikov VI, Uzilevskaya PA. Heart rhythm disorders in mitral valve prolapse syndrome. Cardiology. 1986;(8): 49–53. (In Russ.)

[14] Мыслицкая Г.В., Новиков В.И., Узилевская P.A. Нарушения сердечного ритма при синдроме пролапса митрального клапана // Кардиология. 1986. № 8. С. 49–53.

[15] Myslitskaya GV, Novikov VI, Uzilevskaya PA. Heart rhythm disorders in mitral valve prolapse syndrome. Cardiology. 1986;(8): 49–53. (In Russ.)

[16] Sabbag A, Essayagh B, Barrera JDR, et al. EHRA expert consensus statement on arrhythmic mitral valve prolapse and mitral annular disjunction complex in collaboration with the ESC Council on valvular heart disease and the European Association of Cardiovascular Imaging endorsed cby the Heart Rhythm Society, by the Asia Pacific Heart Rhythm Society, and by the Latin American Heart Rhythm Society. Europace. 2022;24(12):1981–2003. doi: 10.1093/europace/euac125

[17] Sabbag A., Essayagh B., Barrera J.D.R., et al. EHRA expert consensus statement on arrhythmic mitral valve prolapse and mitral annular disjunction complex in collaboration with the ESC Council on valvular heart disease and the European Association of Cardiovascular Imaging endorsed cby the Heart Rhythm Society, by the Asia Pacific Heart Rhythm Society, and by the Latin American Heart Rhythm Society // Europace. 2022. Vol. 24, N 12. P. 1981–2003. doi: 10.1093/europace/euac125

[18] Sabbag A, Essayagh B, Barrera JDR, et al. EHRA expert consensus statement on arrhythmic mitral valve prolapse and mitral annular disjunction complex in collaboration with the ESC Council on valvular heart disease and the European Association of Cardiovascular Imaging endorsed cby the Heart Rhythm Society, by the Asia Pacific Heart Rhythm Society, and by the Latin American Heart Rhythm Society. Europace. 2022;24(12):1981–2003. doi: 10.1093/europace/euac125

[19] Kuzhel DA, Matyushin GV, Savchenko EA. Arrhythmic mitral valve prolapse: new menaces of the known disease. Rational Pharmacotherapy in Cardiology.2023;19(1):77–82. EDN: NGNGWE doi: 10.20996/1819-6446-2023-01-05

[20] Кужель Д.А., Матюшин Г.В., Савченко Е.А. Аритмогенный пролапс митрального клапана: новые угрозы известного заболевания // Рациональная Фармакотерапия в Кардиологии. 2023. Т. 19, № 1. C. 77–82. EDN: NGNGWE doi: 10.20996/1819-6446-2023-01-05

[21] Kuzhel DA, Matyushin GV, Savchenko EA. Arrhythmic mitral valve prolapse: new menaces of the known disease. Rational Pharmacotherapy in Cardiology.2023;19(1):77–82. EDN: NGNGWE doi: 10.20996/1819-6446-2023-01-05

[22] Kubala M, Essayagh B, Michelena HI, et al. Arrhythmic mitral valve prolapse in 2023: Evidence-based update. Front Cardiovasc Med. 2023;10:1130174. doi: 10.3389/fcvm.2023.1130174

[23] Kubala M., Essayagh B., Michelena H.I., et al. Arrhythmic mitral valve prolapse in 2023: Evidence-based update // Front Cardiovasc Med. 2023. Vol. 10. P. 1130174. doi: 10.3389/fcvm.2023.1130174

[24] Kubala M, Essayagh B, Michelena HI, et al. Arrhythmic mitral valve prolapse in 2023: Evidence-based update. Front Cardiovasc Med. 2023;10:1130174. doi: 10.3389/fcvm.2023.1130174

[25] Essayagh B, Sabbag A, Antoine C, et al. Presentation and outcome of arrhythmic mitral valve prolapse. J Am Coll Cardiol. 2020;76(6):637–649. doi: 10.1016/j.jacc.2020.06.029

[26] Essayagh B., Sabbag A., Antoine C., et al. Presentation and outcome of arrhythmic mitral valve prolapse // J Am Coll Cardiol. 2020. Vol. 76, N 6. P. 637–649. doi: 10.1016/j.jacc.2020.06.029

[27] Essayagh B, Sabbag A, Antoine C, et al. Presentation and outcome of arrhythmic mitral valve prolapse. J Am Coll Cardiol. 2020;76(6):637–649. doi: 10.1016/j.jacc.2020.06.029

[28] Basso C, Iliceto S, Thiene G, Perazzolo Marra M. Mitral valve prolapse, ventricular arrhythmias, and sudden death. Circulation. 2019;140(11):952–964. doi: 10.1161/CIRCULATIONAHA.118.034075

[29] Basso C., Iliceto S., Thiene G., Perazzolo Marra M. Mitral valve prolapse, ventricular arrhythmias, and sudden death // Circulation. 2019. Vol. 140, N 11. P. 952–964. doi: 10.1161/CIRCULATIONAHA.118.034075

[30] Basso C, Iliceto S, Thiene G, Perazzolo Marra M. Mitral valve prolapse, ventricular arrhythmias, and sudden death. Circulation. 2019;140(11):952–964. doi: 10.1161/CIRCULATIONAHA.118.034075

[31] Korovesis TG, Koutrolou-Sotiropoulou P, Katritsis DG. Arrhythmogenic mitral valve prolapse. Arrhythm Electrophysiol Rev. 2022;11:e16. doi: 10.15420/aer.2021.28

[32] Korovesis T.G., Koutrolou-Sotiropoulou P., Katritsis D.G. Arrhythmogenic mitral valve prolapse // Arrhythm Electrophysiol Rev. 2022. Vol. 11. P. e16. doi: 10.15420/aer.2021.28

[33] Korovesis TG, Koutrolou-Sotiropoulou P, Katritsis DG. Arrhythmogenic mitral valve prolapse. Arrhythm Electrophysiol Rev. 2022;11:e16. doi: 10.15420/aer.2021.28

[34] Turker Y, Ozaydin M, Acar G, et al. Predictors of ventricular arrhythmias in patients with mitral valve prolapse. Int J Cardiovasc Imaging. 2010;26(2):139–145. doi: 10.1007/s10554-009-9514-6

[35] Turker Y., Ozaydin M., Acar G., et al. Predictors of ventricular arrhythmias in patients with mitral valve prolapse // Int J Cardiovasc Imaging. 2010. Vol. 26, N 2. P. 139–145. doi: 10.1007/s10554-009-9514-6

[36] Turker Y, Ozaydin M, Acar G, et al. Predictors of ventricular arrhythmias in patients with mitral valve prolapse. Int J Cardiovasc Imaging. 2010;26(2):139–145. doi: 10.1007/s10554-009-9514-6

[37] Muthukumar L, Rahman F, Jan MF, et al. The Pickelhaube sign: novel echocardiographic risk marker for malignant mitral valve prolapse syndrome. JACC Cardiovasc Imaging. 2017;10(9): 1078–1080. doi: 10.1016/j.jcmg.2016.09.016

[38] Muthukumar L., Rahman F., Jan M.F., et al. The Pickelhaube sign: novel echocardiographic risk marker for malignant mitral valve prolapse syndrome // JACC Cardiovasc Imaging. 2017. Vol. 10, N 9. P. 1078–1080. doi: 10.1016/j.jcmg.2016.09.016

[39] Muthukumar L, Rahman F, Jan MF, et al. The Pickelhaube sign: novel echocardiographic risk marker for malignant mitral valve prolapse syndrome. JACC Cardiovasc Imaging. 2017;10(9): 1078–1080. doi: 10.1016/j.jcmg.2016.09.016

[40] Han HC, Ha FJ, Teh AW, et al. Mitral valve prolapse and sudden cardiac death: a systematic review. J Am Heart Assoc. 2018;7(23):e010584. doi: 10.1161/JAHA.118.010584

[41] Han H.C., Ha F.J., Teh A.W., et al. Mitral valve prolapse and sudden cardiac death: a systematic review // J Am Heart Assoc. 2018. Vol. 7, N 23. P. e010584. doi: 10.1161/JAHA.118.010584

[42] Han HC, Ha FJ, Teh AW, et al. Mitral valve prolapse and sudden cardiac death: a systematic review. J Am Heart Assoc. 2018;7(23):e010584. doi: 10.1161/JAHA.118.010584

[43] Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022;43(40):3997–4126. doi: 10.1093/eurheartj/ehac262

[44] Zeppenfeld K., Tfelt-Hansen J., de Riva M., et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death // Eur Heart J. 2022. Vol. 43, N 40. P. 3997–4126. doi: 10.1093/eurheartj/ehac262

[45] Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022;43(40):3997–4126. doi: 10.1093/eurheartj/ehac262

[46] Dejgaard LA, Skjølsvik ET, Lie ØH, et al. The mitral annulus disjunction arrhythmic syndrome. J Am Coll Cardiol. 2018;72(14):1600–1609. doi: 10.1016/j.jacc.2018.07.070

[47] Dejgaard L.A., Skjølsvik E.T., Lie Ø.H., et al. The mitral annulus disjunction arrhythmic syndrome // J Am Coll Cardiol. 2018. Vol. 72, N 14. P. 1600–1609. doi: 10.1016/j.jacc.2018.07.070

[48] Dejgaard LA, Skjølsvik ET, Lie ØH, et al. The mitral annulus disjunction arrhythmic syndrome. J Am Coll Cardiol. 2018;72(14):1600–1609. doi: 10.1016/j.jacc.2018.07.070

[49] Alsagaff MY, Shonafi KA, Handari SD, et al. An unexpected overlap syndrome of mitral valve prolapse with COVID-19 related myocarditis: case report from two patients. Ann Med Surg (Lond). 2023;85(4):1276–1281. doi: 10.1097/MS9.0000000000000522

[50] Alsagaff M.Y., Shonafi K.A., Handari S.D., et al. An unexpected overlap syndrome of mitral valve prolapse with COVID-19 related myocarditis: case report from two patients // Ann Med Surg (Lond). 2023. Vol. 85, N 4. P. 1276–1281. doi: 10.1097/MS9.0000000000000522

[51] Alsagaff MY, Shonafi KA, Handari SD, et al. An unexpected overlap syndrome of mitral valve prolapse with COVID-19 related myocarditis: case report from two patients. Ann Med Surg (Lond). 2023;85(4):1276–1281. doi: 10.1097/MS9.0000000000000522

[52] Kitkungvan D, Nabi F, Kim RJ, et al. Myocardial fibrosis in patients with primary mitral regurgitation with and without prolapse. J Am Coll Cardiol. 2018;72(8):823–834. doi: 10.1016/j.jacc.2018.06.048

[53] Kitkungvan D., Nabi F., Kim R.J., et al. Myocardial fibrosis in patients with primary mitral regurgitation with and without prolapse // J Am Coll Cardiol. 2018. Vol. 72, N 8. P. 823–834. doi: 10.1016/j.jacc.2018.06.048

[54] Kitkungvan D, Nabi F, Kim RJ, et al. Myocardial fibrosis in patients with primary mitral regurgitation with and without prolapse. J Am Coll Cardiol. 2018;72(8):823–834. doi: 10.1016/j.jacc.2018.06.048

[55] Constant Dit Beaufils AL, Huttin O, Jobbe-Duval A, et al. Replacement myocardial fibrosis in patients with mitral valve prolapse: relation to mitral regurgitation, ventricular remodeling, and arrhythmia. Circulation. 2021;143(18):1763–1774. doi: 10.1161/CIRCULATIONAHA.120.050214

[56] Constant Dit Beaufils A.L., Huttin O., Jobbe-Duval A., et al. Replacement myocardial fibrosis in patients with mitral valve prolapse: relation to mitral regurgitation, ventricular remodeling, and arrhythmia // Circulation. 2021. Vol. 143, N 18. P. 1763–1774. doi: 10.1161/CIRCULATIONAHA.120.050214

[57] Constant Dit Beaufils AL, Huttin O, Jobbe-Duval A, et al. Replacement myocardial fibrosis in patients with mitral valve prolapse: relation to mitral regurgitation, ventricular remodeling, and arrhythmia. Circulation. 2021;143(18):1763–1774. doi: 10.1161/CIRCULATIONAHA.120.050214

[58] Marra MP, Basso C, De Lazzari M, et al. Morphofunctional abnormalities of mitral annulus and arrhythmic mitral valve prolapse. Circ Cardiovasc Imaging. 2016;9(8):e005030. doi: 10.1161/CIRCIMAGING.116.005030

[59] Marra M.P., Basso C., De Lazzari M., et al. Morphofunctional abnormalities of mitral annulus and arrhythmic mitral valve prolapse // Circ Cardiovasc Imaging. 2016. Vol. 9, N 8. P. e005030. doi: 10.1161/CIRCIMAGING.116.005030

[60] Marra MP, Basso C, De Lazzari M, et al. Morphofunctional abnormalities of mitral annulus and arrhythmic mitral valve prolapse. Circ Cardiovasc Imaging. 2016;9(8):e005030. doi: 10.1161/CIRCIMAGING.116.005030

[61] Han HC, Ha FJ, Teh AW, et al. Mitral valve prolapse and sudden cardiac death: a systematic review. J Am Heart Assoc. 2018;7(23):e010584. doi: 10.1161/JAHA.118.010584

[62] Han H.C., Ha F.J., Teh A.W., et al. Mitral valve prolapse and sudden cardiac death: a systematic review // J Am Heart Assoc. 2018. Vol 7, N 23. P. e010584. doi: 10.1161/JAHA.118.010584

[63] Han HC, Ha FJ, Teh AW, et al. Mitral valve prolapse and sudden cardiac death: a systematic review. J Am Heart Assoc. 2018;7(23):e010584. doi: 10.1161/JAHA.118.010584

[64] Syed FF, Ackerman MJ, McLeod CJ, et al. Sites of successful ventricular fibrillation ablation in bileaflet mitral valve prolapse syndrome. Circ Arrhythm Electrophysiol. 2016;9(5):e004005. doi: 10.1161/CIRCEP.116.004005

[65] Syed F.F., Ackerman M.J., McLeod C.J., et al. Sites of successful ventricular fibrillation ablation in bileaflet mitral valve prolapse syndrome // Circ Arrhythm Electrophysiol. 2016. Vol. 9, N 5. P. e004005. doi: 10.1161/CIRCEP.116.004005

[66] Syed FF, Ackerman MJ, McLeod CJ, et al. Sites of successful ventricular fibrillation ablation in bileaflet mitral valve prolapse syndrome. Circ Arrhythm Electrophysiol. 2016;9(5):e004005. doi: 10.1161/CIRCEP.116.004005

[67] Hong T, Yang M, Zhong L, et al. Ventricular premature contraction associated with mitral valve prolapse. Int J Cardiol. 2016;221: 1144–1149. doi: 10.1016/j.ijcard.2016.06.252

[68] Hong T., Yang M., Zhong L., et al. Ventricular premature contraction associated with mitral valve prolapse // Int J Cardiol. 2016. Vol. 221. P. 1144–1149. doi: 10.1016/j.ijcard.2016.06.252

[69] Hong T, Yang M, Zhong L, et al. Ventricular premature contraction associated with mitral valve prolapse. Int J Cardiol. 2016;221: 1144–1149. doi: 10.1016/j.ijcard.2016.06.252

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