Papillary muscle ventricular arrhythmias in patients with arrhythmic mitral valve prolapse: Electrophysiologic substrate and catheter ablation outcomes

2019 ◽  
Vol 30 (6) ◽  
pp. 827-835 ◽  
Author(s):  
Andres Enriquez ◽  
Yasuhiro Shirai ◽  
Jason Huang ◽  
Jackson Liang ◽  
David Briceño ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Mitral Valve ◽  
Papillary Muscle ◽  
Mitral Valve Prolapse ◽  
Ventricular Arrhythmias

Papillary muscle ventricular arrhythmias among patients with mitral valve prolapse

2018 ◽  
Vol 29 (5) ◽  
pp. E6-E6
Author(s):  
Brian L. Fulton ◽  
Jackson J. Liang ◽  
Andres Enriquez ◽  
Yuchi Han
Keyword(s):  
Mitral Valve ◽  
Papillary Muscle ◽  
Mitral Valve Prolapse ◽  
Ventricular Arrhythmias

Imaging characteristics of papillary muscle site of origin of ventricular arrhythmias in patients with mitral valve prolapse

2017 ◽  
Vol 29 (1) ◽  
pp. 146-153 ◽  
Author(s):  
Brian L. Fulton ◽  
Jackson J. Liang ◽  
Andres Enriquez ◽  
Fermin C. Garcia ◽  
Gregory E. Supple ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Papillary Muscle ◽  
Mitral Valve Prolapse ◽  
Ventricular Arrhythmias ◽  
Imaging Characteristics

Abstract 314: Sensory Innervation of the Papillary Muscle: A Neural Link Between Mitral Valve Prolapse and Malignant Ventricular Arrhythmias?

2016 ◽  
Vol 119 (suppl_1) ◽  
Author(s):  
Krishan J Patel ◽  
Olujimi A Ajijola ◽  
Michael Fishbein ◽  
Kalyanam Shivkumar
Keyword(s):  
Mitral Valve ◽  
Papillary Muscle ◽  
Mitral Valve Prolapse ◽  
Ventricular Arrhythmias ◽  
Left Ventricular ◽  
Sensory Innervation ◽  
Papillary Muscles ◽  
Neuronal Marker ◽  
Significant Difference ◽  
Afferent Innervation

Background: Malignant mitral valve prolapse (MVP) identifies a subset of patients with MVP associated with ventricular arrhythmias (VAs), including sudden cardiac death (SCD). We hypothesized that papillary muscles, which see significant mechanical stress in MVP, are richly innervated with sensory nerves, which induce severe autonomic imbalance on the heart and may trigger malignant VAs. Methods and Results: Longitudinal sections of the anterior and posterior left ventricular papillary muscles, right ventricular outflow tract (RVOT), ventricular septum, and basolateral left ventricular wall (LV) of Yorkshire pigs (n=8) were excised, formalin-fixed, paraffin-embedded, and sectioned. Immuno-staining for protein gene product 9.5 (PGP9.5), a pan-neuronal marker, and calcitonin-gene related peptide (CGRP), a sensory afferent neuron marker, was performed. Areas of immunoreactivity (IR) for CGRP were verified by direct comparison to PGP9.5 IR. The density of CGRP was then compared across anatomical regions. The mean CGRP IR area was 1229.44 ± 116.65 μm 2 /nucleus in papillary muscles, while in the septum, basolateral LV, and RVOT, the CGRP stained areas were 699.36 ± 88.28 μm 2 /nucleus, 681.51 ± 81.90 μm 2 /nucleus, and 381.98 ± 31.14 μm 2 /nucleus, respectively (p<0.001). There was no significant difference between CGRP IR area in the anterior papillary muscle (1091.36 ± 189.82 μm 2 /nucleus) and the posterior papillary muscle (1347.79 ± 140.50 μm 2 /nucleus) (p>0.3). Conclusions: There is a significantly greater amount of afferent innervation in the papillary muscle compared to the septum, basolateral LV, and RVOT. This enrichment of afferent innervation warrants further study to understand how afferent neurotransmission during abnormal mitral valve function may impact ventricular electrophysiology.

Catheter ablation of papillary muscle arrhythmias: Implications of mitral valve prolapse and systolic dysfunction

2018 ◽  
Vol 41 (7) ◽  
pp. 750-758 ◽  
Author(s):  
Adam Lee ◽  
Christian Hamilton‐Craig ◽  
Russell Denman ◽  
Haris M. Haqqani
Keyword(s):  
Catheter Ablation ◽  
Mitral Valve ◽  
Papillary Muscle ◽  
Mitral Valve Prolapse ◽  
Systolic Dysfunction

scholarly journals Malignant Arrhythmic Mitral Valve Prolapse: A Continuum of Clinical Challenges from Diagnosis to Risk Stratification and Patient Management

2020 ◽  
Vol 8 (1) ◽  
pp. 2
Author(s):  
Idit Yedidya ◽  
Aniek L. van Wijngaarden ◽  
Nina Ajmone Marsan
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Ventricular Arrhythmias ◽  
Clinical Decision Making ◽  
Clinical Presentation ◽  
Clinical Decision ◽  
Benign Condition ◽  
Long Period ◽  
Patients Experience ◽  
Hospital Cardiac Arrest

Mitral valve prolapse (MVP) is a common valvular disease, which may remain a benign condition for a long period of time. However, some patients experience malignant ventricular arrhythmias and sudden cardiac death (SCD). It is still largely unknown how to risk-stratify these patients, and no specific recommendations have been proposed to help the clinical decision-making. We present the case of a young man whose first clinical presentation was an out-of-hospital cardiac arrest and was subsequently diagnosed with MVP. We highlighted the possible risk factors for SCD and the challenges in the clinical management of these patients.

scholarly journals P5440Mitral annulus disjunction is associated with severe ventricular arrhythmias independently of mitral valve prolapse

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
L A Dejgaard ◽  
E T Skjolsvik ◽  
O H Lie ◽  
M Ribe ◽  
M K Stokke ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Ventricular Arrhythmias

scholarly journals Long-term outcomes of ablation for ventricular arrhythmias in mitral valve prolapse

2020 ◽  
Author(s):  
Paul J. Marano ◽  
Lisa J. Lim ◽  
Jose M. Sanchez ◽  
Raza Alvi ◽  
Gregory Nah ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Ventricular Arrhythmias ◽  
Long Term Outcomes

scholarly journals P436Abnormal papillary muscle signal on cine CMR images in mitral valve prolapse

2019 ◽  
Vol 20 (Supplement_2) ◽  
Author(s):  
A Scatteia ◽  
C E Pascale ◽  
P Guarini ◽  
S Dellegrottaglie
Keyword(s):  
Mitral Valve ◽  
Papillary Muscle ◽  
Mitral Valve Prolapse ◽  
Cine Cmr
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