Author + information
- Received June 12, 2018
- Revision received August 23, 2018
- Accepted September 4, 2018
- Published online December 3, 2018.
- Marc A. Miller, MDa,∗ (, )@IcahnMountSinai,
- Srinivas R. Dukkipati, MDa@SriniDukkipati,
- Mohit Turagam, MDa,
- Steve L. Liao, MDb,
- David H. Adams, MDc and
- Vivek Y. Reddy, MDa
- aHelmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, New York
- bDivision of Noninvasive Cardiovascular Imaging, Icahn School of Medicine at Mount Sinai, New York, New York
- cDepartment of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
- ↵∗Address for correspondence:
Dr. Marc A. Miller, Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, New York 10029.
There is an increasing awareness of the association between mitral valve prolapse and sudden cardiac death. There are several clinical risk factors associated with an increased risk of mitral valve prolapse–related sudden cardiac death, most of which can be evaluated with noninvasive diagnostic modalities. For example, characteristic changes on the electrocardiogram (T-wave inversions in the inferior leads), complex ventricular ectopy, a spiked configuration of the lateral annular velocities by echocardiography, and evidence of myocardial fibrosis by cardiac magnetic resonance imaging have all been implicated as markers of risk. Herein, the authors review the reported incidence of sudden death to mitral valve prolapse, the clinical profile of at-risk patients, and the basic components necessary to initiate and perpetuate ventricular arrhythmias (substrate and trigger) as well as potential interventions to consider for those at highest risk.
Dr. Miller has served as a consultant to Boston Scientific. Dr. Dukkipati has received research grant support from Biosense Webster. Dr. Reddy has received research grants from and served as a consultant for Biosense Webster, Boston Scientific, and Abbott. Dr. Adams has received grant support from Medtronic; has served as the National Co-Principal Investigator of the Medtronic APOLLO FDA Pivotal Trial, NeoChord ReChord FDA Pivotal Trial, Medtronic CoreValve U.S. Pivotal Trial, and Abbott TRILUMINATE Pivotal Trial; and has received royalty agreements through Mount Sinai School of Medicine with Medtronic and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received June 12, 2018.
- Revision received August 23, 2018.
- Accepted September 4, 2018.
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