Tpeak-Tend interval predicts VT inducibility in arrhythmogenic mitral valve prolapse syndrome

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Abstract Background Mitral valve prolapse (MVP) is commonly benign, but an arrhythmic phenotype (AMVP) with increased risk for sudden cardiac death has been described. A prolonged T peak -T end interval has been association with increased arrhythmic risk in different clinical settings. The aim of this study was to investigate a possible correlation between prolonged T peak -T end interval and ventricular tachycardia (VT) inducibility in MVP. Methods and results Sixty-five patients fulfilling the EHRA criteria of AMVP syndrome underwent programmed ventricular stimulation between 2016 and 2024. Sustained polymorphic VT was induced in 19 patients (29.2%) and was significantly associated with prolonged T peak -T end (100.5 ± 10.3 ms vs. 85.1 ± 9.9 ms, p = 0.002) and prolonged T peak -T end /QTc (0.24 ± 0.03 vs. 0.2 ± 0.02, p = 0.004). Conclusion Prolonged T peak -T end was associated with VT inducibility in patients with AMVP syndrome, suggesting its potential value as simple ECG-based marker for risk stratification. If T peak -T end also correlates with clinical outcome should be investigated in prospective studies. Graphical Abstract

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