Abstract
Background: Mitral valve prolapse (MVP) is a common valvular heart disease affecting approximately 2–3% of the population. In recent years, multiple studies have emphasized that cardiac arrhythmias are central to the clinical profiles of MVP. Early detection and accurate evaluation of associated arrhythmias are essential for guiding treatment, improving prognosis, and preventing disease progression.
Objective: To describe the characteristics of cardiac arrhythmias detected on 24-hour Holter electrocardiography and to identify factors associated with arrhythmias in patients with primary mitral regurgitation secondary to mitral valve prolapse.
Methods: A cross-sectional study, including 100 patients with severe mitral regurgitation due to mitral valve prolapse at the Vietnam National Heart Institute, Bach Mai Hospital.
Results: The mean age of the study group was 61.8 ± 15.5 years, with females accounting for 42%. Ventricular arrhythmias were observed in 52% of patients, including 14% with a premature ventricular contraction (PVC) burden > 5% and 14% with nonsustained ventricular tachycardia (NSVT). Presence of ventricular arrhythmias was associated with younger age (≤ 40 years, p = 0.002), inverted T waves in inferior or lateral leads (p = 0.02), and bileaflet mitral valve prolapse on echocardiography (p = 0.049). Atrial arrhythmias were observed in 62% of patients, including 62% with premature atrial contractions (PACs), 27% with atrial tachycardia, and 27% with atrial fibrillation. Significant predictors of atrial arrhythmias included older age (≥ 60 years, p = 0.008), dyspnea particularly in patients with NYHA class III or higher left atrial diameter ≥ 45 mm (p = 0.009), left atrial volume index (LAVi) ≥ 60 mL/m² (p = 0.039), left ventricular end-diastolic diameter (LVEDD) > 60 mm (p = 0.024), left ventricular ejection fraction (LVEF) ≤ 60% (p = 0.001), and elevated NT-proBNP levels (p = 0.001).