202 | Chapter 10 ABSTRACT Background Idiopathic ventricular fibrillation (IVF) is diagnosed in patients with ventricular fibrillation of which the origin is not identified after extensive evaluations. Recent studies suggest an association between mitral annulus disjunction (MAD), mitral valve prolapse (MVP) and ventricular arrhythmias. The prevalence of MAD and MVP in IVF patients in this regard, is not well established. We aimed to explore the prevalence of MAD and MVP in a consecutive cohort of IVF patients compared to matched controls. Methods and Results In this retrospective multicenter cohort study, cardiac magnetic resonance images from IVF patients (i.e., negative for ischemia, cardiomyopathy and channelopathies) and age- and sexmatched control subjects were analyzed for the presence of MAD (≥2mm) and MVP (>2mm). In total, 72 patients (mean age 39±14 years, 42% female) and 72 control subjects (mean age 41±11 years, 42% female) were included. MAD in the inferolateral wall was more prevalent in IVF patients versus healthy controls (7 [11%] vs. 1 [1%], p=0.024). MVP was only seen in IVF patients and not in controls (5 [7%] vs. 0 [0%], p=0.016). MAD was observed in both patients with (n=4) and without (n=3) MVP. Conclusion Inferolateral MAD and MVP were significantly more prevalent in IVF patients compared to healthy controls. The authors advocate that evaluation of the mitral valve region deserves extra attention in the extensive screening of patients with unexplained cardiac arrest. These findings support further exploration of the pathophysiological mechanisms underlying a subset of IVF that associates with MAD and MVP.
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