Mitral valve prolapse (MVP) affects up to 3% of the general population and a small subset of patients is at risk for ventricular arrhythmias. This subgroup is referred to as AMVP (arrhythmic MVP) and was recently defined using the following criteria: (1) Presence of MVP), (2) Ventricular arrhythmia that is either frequent (≥5% total premature ventricular contraction (PVC) burden on Holter) or complex (non-sustained ventricular tachycardia (nsVT), ventricular tachycardia (VT), or ventricular fibrillation (VF)), and (3) The absence of any other well-defined arrhythmic substrate.

Currently, diagnosis is often based on repeated 24-hour Holter monitoring. However, the ventricular arrhythmia burden varies from day-to-day and long-term rhythm monitoring has shown in other pathologies to increase the diagnostic yield with up to 200% (from 22.5% on 24h to 75.3% on 14 days).

This pilot study aims to study the diagnostic yield of long-term rhythm monitoring in patients with MVP as well as the day-to-day variability of ventricular arrhythmias to facilitate power calculation for a future large-scale prospective registry.

Inclusion Criteria:

• Patients aged 18 years or older
• Mitral valve prolapse diagnosed on previous echocardiography or cardiac MRI
• New York Heart association classification ≥3 for cohort 3 and classification 1 or 2 for cohorts 1 and 2
• Willing and able to provide signed written informed consent
• No contra-indication for long-term monitoring (known allergy to adhesives)

Exclusion Criteria:

• Prior cardiac surgery, including previous mitral valve intervention
• Prior endovascular mitral valve repair (MitraClip)
• Previous catheter ablation of ventricular arrhythmias
• Patients not in sinus rhythm
• Patients on anti-arrhythmic drugs but betablockers
• Known alternative arrhythmic substrate, for example previous myocardial infarction
• Known allergy to adhesives