Abstract 14128: Frequency of Mitral Annular Disjunction and Prolapse in Patients Undergoing Premature Ventricular Contraction Ablation

• Published in: Circulation (New York, N.Y.) Vol. 140; no. Suppl_1 Suppl 1; p. A14128
• Main Authors: Beri, Neil, Takeda, Patricia, Malhotra, Pankaj, Zhang, Xin, Fan, Dali, Pezeshkian, Nayereh, Srivatsa, Uma
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 19.11.2019
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.14128

IntroductionMitral annular disjunction (MAD) is an abnormal displacement of the mitral annulus away from the ventricular myocardium. It is often associated with mitral valve prolapse (MVP) and may be a risk factor for ventricular arrhythmias originating from the papillary muscles.HypothesisWe assessed the hypothesis that mitral annular disjunction would be more commonly found in patients undergoing papillary muscle (PM) premature ventricular contraction (PVC) ablation as compared with controls (those undergoing right ventricular outflow tract (RVOT) PVC ablation).MethodsWe retrospectively assessed the echocardiograms as well as baseline characteristics of a cohort of patients who had undergone PM PVC ablation (n=30) and a comparator cohort who had undergone RVOT PVC ablation (n=65) to determine whether MAD or MVP were present.ResultsPatients undergoing PM PVC ablation were older (61.9 yrs vs 52.3 yrs; p<0.01), more likely to be male (60.0% vs 30.8%; p=0.01) and have a history of coronary artery disease (43.3% vs 10.8%; p<0.01), myocardial infarction (30.0% vs 0.0%; p<0.01), and percutaneous coronary intervention (26.7% vs 6.2%; p=0.01). MAD was present in two patients (6.7%) undergoing PM PVC ablation as compared with zero patients (0.0%) undergoing RVOT PVC ablation (p=0.04). MVP was present in two patients (6.7%) undergoing PM PVC ablation as compared with one patient (1.5%) undergoing RVOT PVC ablation (p=0.18). Any mitral valve pathology (MVP or MAD) was present in three patients (10.0%) undergoing PM PVC ablation as compared with one patient (1.5%) undergoing RVOT PVC ablation (p=0.06).ConclusionsMAD was more common in patients undergoing PM PVC ablation as compared with RVOT PVC ablation.