Arrhythmias in mitral valve prolapse. Effect of selection bias

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Abstract
To assess the contribution of bias in subject selection to the prevalence of arrhythmias in cases of mitral valve prolapse (MVP), ambulatory arrhythmias were compared in 63 patients with MVP and 28 symptom-matched control subjects. All subjects were in sinus rhythm. Mean 24-h heart rate of the prolapse population was lower than that of the control group (76 vs. 82 beats/min). Mean atrial premature complex (APC) density per 1000 beats (0.9 vs. 0.7 for patients with MVP and control subjects, respectively) and mean ventricular premature complex (VPC) density per 1000 total beats (1.2 vs. 1.5) did not differ between groups. Small differences between groups in APC and VPC complexity did not reach statistical significance. Compared with similarly symptomatic controls, patients with MVP evidently do not have as high as excess prevalence of arrhythmias as previously believed.