title: [Relationship between mitral valve prolapse and arrhythmogenic right ventricular disease].
abstract: OBJECTIVE
  To evaluate some features of ventricular arrhythmias in patients with mitral valve prolapse.
  
  
  METHODS
  We studied 25 patients (female: 19; mean age: 37 +/- 13 years) with ventricular arrhythmias, mitral valve prolapse and normal ventricular function. All patients underwent a 24h Holter and high resolution ECG (HRECG). The Qtc intervals were measured in lead II (normal < 0.44 s). In order to define the possible origin of the ventricular focus, the morphology of the ectopic beats were analysed in leads I, II, aVF, V1 using the following criteria: 1) LBBB morphology with left axis deviation in the frontal plane (FP): origin at the inflow tract of the right ventricle (RV); 2) LBBB morphology with right axis deviation in the FP: origin at the outflow tract of the RV; 3) RBBB morphology with left axis deviation in the FP: origin at the posterior region of the left ventricle (LV). RBBB morphology with right axis deviation in the FP: origin at the anterior region of the LV.
  
  
  RESULTS
  Twenty three (92%) patients showed > 720 isolated ventricular ectopic beats/24 h. Paired ventricular response was detected in 18 (72%) patients and non-sustained VT in 15 (60%). HRECG was positive in six (24%) patients and Qtc interval was prolonged in 13 (52%). RV was the site of origin of the ventricular ectopic beats in 85% of the patients (outflow: 85%; inflow: 15%). Only five (20%) patients had arrhythmias from the LV.
  
  
  CONCLUSIONS
  There was a high incidence of ventricular arrhythmias with a low incidence of positive HRECG tests, suggesting that the mechanisms of the arrhythmias do not correlate with slow intramyocardial conduction. It was noted a strong association between mitral valve prolapse, arrhythmogenic right ventricular disease and Qtc prolongation. It is possible that in some of this patients the finding could represent a global myocardial disease.
authors.affiliation: Hospital Pró-Cardíaco/Pró-Ritmo-Rio de Janeiro.
authors.forename: A M
authors.initials: AM
authors.lastname: Costa
authors.forename: I G
authors.initials: IG
authors.lastname: Maia
authors.forename: F
authors.initials: F
authors.lastname: Cruz Filho
authors.forename: M L
authors.initials: ML
authors.lastname: Fagundes
authors.forename: R
authors.initials: R
authors.lastname: Sá
authors.forename: P
authors.initials: P
authors.lastname: Alves
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000000981:diagnostic imaging; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000150:complications* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000150:complications* / Q000000981:diagnostic imaging
vernacular_title: Associação entre prolapso valvar mitral e doença ventricular direita arritmogênica.