Abstract 14820: Is Mitral Annular Disjunction Associated With Atrial Fibrillation?

Abstract

Introduction: Mitral annular disjunction has been associated with increased risk of ventricular arrhythmias. However, its association with atrial fibrillation (AF) in mitral valve prolapse (MVP) is unknown. Hypothesis: Mitral annular disjunction (MAD) is associated with atrial fibrillation in patients with MVP. Methods: We studied all patients aged 18 - 90 years with MVP on echocardiography between 2016-19 at our institution. Echocardiograms were reviewed for ventricular size and function and mitral valve pathology. Comorbidities, including atrial fibrillation, were identified on chart review. Multivariate logistic regression was used to assess the association of mitral morphologic factors and clinical characteristics with AF in MVP. Results: AF was present in 135 (21.2%) of a total 637 MVP patients. AF was present in 5.3% (11/209) under age 60 years, 19.8% (50/253) age 60-75 years, and 43.3% (74/175) over age 75 years. MAD was present in 15.6% (21/135) with AF and 14.7% (74/502) without AF (p=0.79). On multivariate analysis, atrial fibrillation was associated with increased age (OR [95% CI], 1.93 [1.59-2.36] per 10 years, p<0.0001) and heart failure (OR 2.70 [1.62-4.51], p=0.0001), although not moderate or severe mitral regurgitation (OR 1.20 [0.75-1.92], p=0.45). Conclusion: Atrial fibrillation is highly prevalent in mitral valve prolapse and independently associated with older age and presence of heart failure. Mitral annular disjunction is not a risk factor for atrial fibrillation in mitral valve prolapse.