Arrhythmogenic mitral valve prolapse—a systematic review of ventricular arrhythmia and sudden cardiac death outcomes before and after mitral valve surgery

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia Pub Date : 2025-07-15 DOI:10.1002/joa3.70108

James N. Cameron BSc, MEng, MBBS, Nigel Sutherland BPhysio, MD, FRACP, Chee Loong Chow MBBS, FRACP, Hui-Chen Han MBBS, PhD, FRACP, Matias Yudi MBBS, PhD, FRACP, Rajiv Mahajan MBBS, MD, PhD, FRACP, Anand Ganesan MBBS, PhD, FRACP, Avi Sabbag MD, PhD, Kristina H. Haugaa MD, PhD, FESC, Jai Raman MBBS, PhD, FRACS, Prashanthan Sanders MBBS, PhD, FRACP, Omar Farouque MBBS, PhD, FRACP, Han S. Lim MBBS, PhD, FRACP

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Abstract

Background

Several autopsy and observational studies have investigated the link between mitral valve prolapse (MVP) and sudden cardiac death (SCD) given the well accepted yet rare occurrence of ventricular arrhythmias (VA). Whether surgical intervention for arrhythmogenic MVP (aMVP) reduces VA and SCD risk remains unknown.

Methods

A systematic literature review was conducted using the PubMed database in December 2024. Studies documented in English were included if patients had undergone mitral valve (MV) surgery (MVS; repair or replacement) for MVP with documented rates of VA or SCD pre- and postintervention.

Results

Sixteen identified studies (8 cohort and 8 case studies) comprised 1233 patients (receiving medical or surgical treatment) with a pooled mean age of 61.5 years and 41.9% being female. A total of 657 MVP patients underwent MVS. Seven cohort studies reported rates of VA pre- and postintervention, with six of these and all case studies reporting a significant reduction. The remaining cohort study reported a reduction in SCD.

Conclusions

This systematic review indicates a reduction in VA following current guideline-directed MVS for MVP. However, a residual risk of VA and SCD may remain postintervention.

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心律失常致二尖瓣脱垂——二尖瓣手术前后室性心律失常和心源性猝死的系统回顾

背景：鉴于室性心律失常（VA）的罕见发生，一些尸检和观察性研究已经调查了二尖瓣脱垂（MVP）和心源性猝死（SCD）之间的联系。致心律失常MVP （aMVP）的手术干预是否能降低VA和SCD的风险尚不清楚。方法采用2024年12月PubMed数据库进行系统的文献综述。如果患者接受了二尖瓣（MV）手术(MVS；修复或更换)，并记录干预前后VA或SCD的发生率。结果16项确定的研究（8项队列研究和8项病例研究）包括1233例患者（接受内科或外科治疗），合并平均年龄为61.5岁，41.9%为女性。共有657名MVP患者接受了MVS。七项队列研究报告了干预前后的VA率，其中六项和所有病例研究报告了显著降低。其余的队列研究报告了SCD的减少。结论：本系统综述表明，采用目前指导的MVS治疗MVP可减少VA。然而，干预后VA和SCD的残留风险可能仍然存在。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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