PO-05-157 DOES THE SURFACE ECG PROVIDE CLUES TO THE PRESENCE OF MITRAL ANNULAR DISJUNCTION IN PATIENTS WITH MITRAL VALVE PROLAPSE?

Mitral annular disjunction (MAD) is an increasingly recognized entity that usually accompanies mitral valve prolapse (MVP) and associated with a small risk of ventricular arrhythmias. There are no established ECG findings MAD, detection MAD relies primarily on imaging techniques such as echocardiography or MRI. To discern surface clues to the presence in patients MVP. We developed registry all MVP from 2019 onwards. All echocardiograms ECGs were reviewed. Exclusion criteria: QRS duration >120ms, left hypertrophy, frequent PVCs (to remove confounding effects T wave memory), non-sinus rhythm, prior surgery. Patients divided into two groups: MVP+MAD MVP-only. measuring ≥2 mm parasternal long-axis view at end-systole included group; other assigned MVP-only group. “pseudo-MAD” (where leaflet flattens against atrial wall during systole) also group after review by experienced echocardiographer. analyzed for rate, axes, discordance inferior leads, PR, QRS, QT, QTc. Total=378 (MVP+MAD: n=62; MVP-only: n=316). Surface leads II III showed greater incidence compared (Lead II: p=0.038; Lead III: p=0.0125, see Table 1). + patients, show QRS-T leads. The absence excludes NPV 86% 88% III.