{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:05:39Z","timestamp":1788822339600,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T00:00:00Z","timestamp":1552867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Mitral valve prolapse (MVP) is a common valve condition and has been associated with sudden cardiac death. Premature ventricular contractions (PVCs) from the papillary muscles (PMs) may play a role as triggers for ventricular fibrillation (VF) in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To characterize the electrophysiological substrate and outcomes of catheter ablation in patients with MVP and PM PVCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Of 597 patients undergoing ablation of ventricular arrhythmias during the period 2012\u20102015, we identified 25 patients with MVP and PVCs mapped to the PMs (64% female). PVC\u2010triggered VF was the presentation in 4 patients and a fifth patient died suddenly during follow\u2010up. The left ventricle ejection fraction (LVEF) was 50.5%\u2009\u00b1\u200911.8% and PVC burden was 24.4%\u2009\u00b1\u200913.1%. A cardiac magnetic resonance imaging was performed in nine cases and areas of late gadolinium enhancement were found in four of them. A detailed LV voltage map was performed in 11 patients, three of which exhibited bipolar voltage abnormalities. Complete PVC elimination was achieved in 19 (76%) patients and a significant reduction in PVC burden was observed in two (8%). In patients in which the ablation was successful, the PVC burden decreased from 20.4%\u2009\u00b1\u200910.8% to 6.3%\u2009\u00b1\u20099.5% (<jats:italic>P<\/jats:italic>\u2009=\u20090.001). In 5\/6 patients with depressed LVEF and successful ablation, the LV function improved postablation. No significant differences were identified between patients with and without VF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PM PVCs are a source of VF in patients with MVP and can induce PVC\u2010mediated cardiomyopathy that reverses after PVC suppression. Catheter ablation is highly successful with more than 80% PVC elimination or burden reduction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13900","type":"journal-article","created":{"date-parts":[[2019,3,7]],"date-time":"2019-03-07T03:30:06Z","timestamp":1551929406000},"page":"827-835","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Papillary muscle ventricular arrhythmias in patients with arrhythmic mitral valve prolapse: Electrophysiologic substrate and catheter ablation outcomes"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8146-360X","authenticated-orcid":false,"given":"Andres","family":"Enriquez","sequence":"first","affiliation":[{"name":"Division of Cardiology Queen\u2019s University Kingston Ontario Canada"},{"name":"Section of Cardiac Electrophysiology, Department of Medicine Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Shirai","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Department of Medicine Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Huang","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Department of Medicine Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8608-8899","authenticated-orcid":false,"given":"Jackson","family":"Liang","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Department of Medicine Hospital of the University of Pennsylvania Philadelphia 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Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4905-8142","authenticated-orcid":false,"given":"Brian","family":"Fulton","sequence":"additional","affiliation":[{"name":"Department of Medicine Cardiovascular Division, Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchi","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Medicine Cardiovascular Division, Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Perez","sequence":"additional","affiliation":[{"name":"Arrhythmia Service, Department of Medicine Hospital Guillermo Gran Benavente Concepcion Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9276-4857","authenticated-orcid":false,"given":"David 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