van Wijngaarden AL, de Riva M, Hiemstra YL, et al. - This study was conducted among patients experiencing mitral valve prolapse (MVP) (fibro-elastic deficiency or Barlow’s disease) referred for mitral valve (MV) surgery due to moderate-to-severe mitral regurgitation (MR) in order to determine the prevalence of symptomatic ventricular arrhythmias (VA) as well as to explore clinical, electrocardiographic, standard and advanced echocardiographic parameters related to VA. Participants were 610 consecutive patients (64±12 years, 36% female). Findings revealed a relatively frequent prevalence of symptomatic VA as well as its link with significant MV annular abnormalities, subtle left ventricular function impairment and heterogeneous contraction in patients with MVP with moderate-to-severe MR. Evaluation of these parameters might aid not only decision-making over further diagnostic analyses but also improve risk-stratification. The factors that showed independent connection with symptomatic VA were: female gender, increased MV annular diameter, lower global longitudinal strain and prolonged mechanical dispersion.