Arrhythmic mitral valve prolapse has been identified as a potential cause of sudden cardiac death among some patients with primary mitral regurgitation. What are critical indications and possible mechanisms? In this discussion, we review:

• Why patients with mild to moderate mitral regurgitation are at higher risk than those with severe regurgitation.
• Why patients with bileaflet prolapse are at increased risk over those with isolated posterior leaflet mitral valve prolapse.
• Why the complexity of Premature Ventricular Contractions (PVC), rather than the number of PVCs, matters most in assessing risk in patients suffering mitral valve prolapse
• How changes in the structure of the ventricular myocardium are extremely important in identifying patients at risk for sudden cardiac death. 

Marc Miller, MD
Associate Professor of Cardiology
Icahn School of Medicine at Mount Sinai 

Dimos Pandis, MD
Assistant Professor, Associate Director for Clinical Research & Education
Department of Cardiovascular Surgery
Icahn School of Medicine at Mount Sinai

Randolph P. Martin, MD
Clinical Professor, Department of Cardiovascular Surgery
Icahn School of Medicine at Mount Sinai