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Effects of atrial fibrillation and heart rate on percutaneous mitral valve repair with MitraClip: results from the TRAnscatheter Mitral valve Interventions (TRAMI) registry.
EuroIntervention. 2017 Feb 20; 12(14):1697-1705.E

Abstract

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.

Authors+Show Affiliations

Zentrum für Kardiologie, Kardiologie 1, Universitätsmedizin Mainz, Mainz, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28216472

Citation

Jabs, Alexander, et al. "Effects of Atrial Fibrillation and Heart Rate On Percutaneous Mitral Valve Repair With MitraClip: Results From the TRAnscatheter Mitral Valve Interventions (TRAMI) Registry." EuroIntervention : Journal of EuroPCR in Collaboration With the Working Group On Interventional Cardiology of the European Society of Cardiology, vol. 12, no. 14, 2017, pp. 1697-1705.
Jabs A, von Bardeleben RS, Boekstegers P, et al. Effects of atrial fibrillation and heart rate on percutaneous mitral valve repair with MitraClip: results from the TRAnscatheter Mitral valve Interventions (TRAMI) registry. EuroIntervention. 2017;12(14):1697-1705.
Jabs, A., von Bardeleben, R. S., Boekstegers, P., Puls, M., Lubos, E., Bekeredjian, R., Ouarrak, T., Plicht, B., Eggebrecht, H., Nickenig, G., Butter, C., Hoffmann, R., Senges, J., & Hink, U. (2017). Effects of atrial fibrillation and heart rate on percutaneous mitral valve repair with MitraClip: results from the TRAnscatheter Mitral valve Interventions (TRAMI) registry. EuroIntervention : Journal of EuroPCR in Collaboration With the Working Group On Interventional Cardiology of the European Society of Cardiology, 12(14), 1697-1705. https://doi.org/10.4244/EIJ-D-16-00115
Jabs A, et al. Effects of Atrial Fibrillation and Heart Rate On Percutaneous Mitral Valve Repair With MitraClip: Results From the TRAnscatheter Mitral Valve Interventions (TRAMI) Registry. EuroIntervention. 2017 Feb 20;12(14):1697-1705. PubMed PMID: 28216472.
* Article titles in AMA citation format should be in sentence-case
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 - 2017/2/21/entrez PY - 2017/2/22/pubmed PY - 2017/11/9/medline SP - 1697 EP - 1705 JF - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JO - EuroIntervention VL - 12 IS - 14 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. SN - 1969-6213 UR - https://www.unboundmedicine.com/medline/citation/28216472/Effects_of_atrial_fibrillation_and_heart_rate_on_percutaneous_mitral_valve_repair_with_MitraClip:_results_from_the_TRAnscatheter_Mitral_valve_Interventions__TRAMI__registry_ L2 - http://www.pcronline.com/eurointervention/111th_issue/279 DB - PRIME DP - Unbound Medicine ER -