Lifetime exercise dose and ventricular arrhythmias in patients with mitral valve prolapse

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Abstract

Aims

Patients with mitral valve prolapse (MVP) have high risk of life-threatening ventricular arrhythmias (VAs). Data on the impact of exercise on arrhythmic risk in these patients are lacking. We explored whether lifetime exercise dose was associated with severe VA and with established risk factors in patients with MVP. Furthermore, we explored the circumstances at the VA event.

Methods and results

In this retrospective cohort study, we included patients with MVP and assessed lifetime exercise dose as metabolic equivalents of task (MET) hours/week. Severe VA was defined as sustained ventricular tachycardia or fibrillation, aborted cardiac arrest, and appropriate shock by a primary preventive implantable cardioverter defibrillator. We included 136 MVP patients (48 years [interquartile range (IQR) 35–59], 61% female), and 17 (13%) had previous severe VA. The lifetime exercise dose did not differ in patients with and without severe VA (17 MET h/week [IQR 9–27] vs. 14 MET h/week [IQR 6–31], P = 0.34). Lifetime exercise dose > 9.6 MET h/week was a borderline significant marker for severe VA (OR 3.38, 95% CI 0.92–12.40, P = 0.07), while not when adjusted for age (OR 2.63, 95% CI 0.66–10.56, P = 0.17). Ventricular arrhythmia events occurred most frequently during wakeful rest (53%), followed by exercise (29%) and sleep (12%).

Conclusion

We found no clear association between moderate lifetime exercise dose and severe VA in patients with MVP. We cannot exclude an upper threshold for safe levels of exercise. Further studies are needed to explore exercise and risk of severe VA.

Graphical Abstract

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Author and article information

Contributors

Christian K Five:

ORCID: https://orcid.org/0000-0002-2376-0884

Nina E Hasselberg

Linda T Aaserud:

ORCID: https://orcid.org/0000-0003-2056-2441

Anna Isotta Castrini:

ORCID: https://orcid.org/0000-0001-9466-856X

Katarina Vlaisavljevic:

ORCID: https://orcid.org/0000-0003-1434-8932

Øyvind Lie:

ORCID: https://orcid.org/0000-0003-1663-1117

Christine Rootwelt-Norberg:

ORCID: https://orcid.org/0000-0002-4312-9969

Eivind W Aabel:

ORCID: https://orcid.org/0000-0002-2022-4568

Kristina H Haugaa:

ORCID: https://orcid.org/0000-0002-4900-0453

Journal

Journal ID (nlm-ta): Europace

Journal ID (iso-abbrev): Europace

Journal ID (publisher-id): europace

Title: Europace

Publisher: Oxford University Press (US )

ISSN (Print): 1099-5129

ISSN (Electronic): 1532-2092

Publication date Collection: October 2023

Publication date (Electronic): 18 October 2023

Publication date PMC-release: 18 October 2023

Volume: 25

Issue: 10

Electronic Location Identifier: euad309

Affiliations

Department of Cardiology, ProCardio Center for Innovation, Oslo University Hospital, Rikshospitalet , PO Box 4950 Nydalen, 0424 Oslo, Norway