Conti Sergio, Sabatino Francesco, Caserta Carlo, Sgarito Giuseppe
Department of Cardiology, Electrophysiology Department, ARNAS Ospedali Civico Di Cristina Benfratelli, Palermo, Italy.
Department of Cardiology, cardiovascular imaging division, ARNAS Ospedali Civico Di Cristina Benfratelli, Palermo, Italy.
Echocardiography. 2023 Mar;40(3):271-275. doi: 10.1111/echo.15529. Epub 2023 Jan 31.
Patients with mitral valve prolapse (MVP) have a heterogeneous clinical spectrum, ranging from benign to severe clinical presentations such as sudden cardiac death (SCD). Some of the markers of "arrhythmic MVP" include inverted/biphasic T-waves, QT prolongation, and polymorphic premature ventricular contractions (PVCs) originating from the left ventricular outflow tract and papillary muscles (PMs). The genesis of arrhythmias in MVP recognizes the combination of the substrate (fibrosis) and the trigger (mechanical stretch). Therefore, ablation of ventricular arrhythmias originating from PMs in a patient with MVP can be considered an adjunctive strategy to lower the arrhythmic burden and reduce the risk of ICD shocks.
二尖瓣脱垂（MVP）患者具有异质性临床谱，从良性表现到诸如心源性猝死（SCD）等严重临床表现不等。“心律失常性MVP”的一些标志物包括倒置/双向T波、QT间期延长以及源自左心室流出道和乳头肌（PMs）的多形性室性早搏（PVCs）。MVP中心律失常的发生机制认识到了基质（纤维化）和触发因素（机械牵张）的联合作用。因此，对于MVP患者，消融源自PMs的室性心律失常可被视为一种辅助策略，以减轻心律失常负担并降低植入式心律转复除颤器（ICD）电击风险。
