Effects of atrial fibrillation and heart rate on percutaneous mitral valve repair with MitraClip: results from the TRAnscatheter Mitral valve Interventions (TRAMI) registry

TY - JOUR

T1 - Effects of atrial fibrillation and heart rate on percutaneous mitral valve repair with MitraClip: results from the TRAnscatheter Mitral valve Interventions (TRAMI) registry

AU - Jabs, Alexander

AU - von Bardeleben, Ralph S

AU - Boekstegers, Peter

AU - Puls, Miriam

AU - Lubos, Edith

AU - Bekeredjian, Raffi

AU - Ouarrak, Taoufik

AU - Plicht, Björn

AU - Eggebrecht, Holger

AU - Nickenig, Georg

AU - Butter, Christian

AU - Hoffmann, Rainer

AU - Senges, Jochen

AU - Hink, Ulrich

PY - 2017/2/20

Y1 - 2017/2/20

N2 - AIMS: In patients undergoing percutaneous edge-to-edge mitral valve repair for mitral valve regurgitation (MR), our aim was to evaluate acute and follow-up differences with pre-existing sinus rhythm (SR) or atrial fibrillation (AF), as well as comparisons stratified by baseline heart rate.METHODS AND RESULTS: Seven hundred and sixty patients who underwent a MitraClip procedure were prospectively enrolled in the TRAnscatheter Mitral valve Interventions (TRAMI) registry, and stratified according to baseline heart rhythm and heart rate with a cut-off value of 70 beats per minute. Technical success, procedural characteristics and MR reduction were similar throughout the subgroups. Overall, in-hospital adverse event rates were low in this high-risk patient collective. At 12 months, survival was higher in SR (83.5%) than AF patients (74.9%, p<0.05), while the cumulative major adverse cardio-cerebrovascular event rate did not differ, and a sustained improvement of NYHA functional class occurred in all subgroups.CONCLUSIONS: These registry data, comprising the largest number of unselected "real-world" MitraClip patients, suggest that the intervention can be performed safely and effectively, and reduces MR in the majority of patients irrespective of baseline rhythm or heart rate. While 12-month survival was higher for patients with SR, overall MACCE and clinical improvement did not differ between the subgroups.

AB - AIMS: In patients undergoing percutaneous edge-to-edge mitral valve repair for mitral valve regurgitation (MR), our aim was to evaluate acute and follow-up differences with pre-existing sinus rhythm (SR) or atrial fibrillation (AF), as well as comparisons stratified by baseline heart rate.METHODS AND RESULTS: Seven hundred and sixty patients who underwent a MitraClip procedure were prospectively enrolled in the TRAnscatheter Mitral valve Interventions (TRAMI) registry, and stratified according to baseline heart rhythm and heart rate with a cut-off value of 70 beats per minute. Technical success, procedural characteristics and MR reduction were similar throughout the subgroups. Overall, in-hospital adverse event rates were low in this high-risk patient collective. At 12 months, survival was higher in SR (83.5%) than AF patients (74.9%, p<0.05), while the cumulative major adverse cardio-cerebrovascular event rate did not differ, and a sustained improvement of NYHA functional class occurred in all subgroups.CONCLUSIONS: These registry data, comprising the largest number of unselected "real-world" MitraClip patients, suggest that the intervention can be performed safely and effectively, and reduces MR in the majority of patients irrespective of baseline rhythm or heart rate. While 12-month survival was higher for patients with SR, overall MACCE and clinical improvement did not differ between the subgroups.

KW - Aged

KW - Aged, 80 and over

KW - Atrial Fibrillation/physiopathology

KW - Cardiac Catheterization/adverse effects

KW - Female

KW - Heart Rate/physiology

KW - Heart Valve Prosthesis/adverse effects

KW - Heart Valve Prosthesis Implantation/methods

KW - Humans

KW - Male

KW - Mitral Valve/physiopathology

KW - Mitral Valve Insufficiency/physiopathology

KW - Postoperative Complications/physiopathology

KW - Registries

KW - Treatment Outcome

U2 - 10.4244/EIJ-D-16-00115

DO - 10.4244/EIJ-D-16-00115

M3 - SCORING: Journal article

C2 - 28216472

VL - 12

SP - 1697

EP - 1705

JO - EUROINTERVENTION

JF - EUROINTERVENTION

SN - 1774-024X

IS - 14

ER -