title: Effects of atrial fibrillation and heart rate on percutaneous mitral valve repair with MitraClip: results from the TRAnscatheter Mitral valve Interventions (TRAMI) registry.
abstract: OBJECTIVE
  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.
  
  
  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.affiliation: Zentrum für Kardiologie, Kardiologie 1, Universitätsmedizin Mainz, Mainz, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Jabs
authors.forename: Ralph S
authors.initials: RS
authors.lastname: von Bardeleben
authors.forename: Peter
authors.initials: P
authors.lastname: Boekstegers
authors.forename: Miriam
authors.initials: M
authors.lastname: Puls
authors.forename: Edith
authors.initials: E
authors.lastname: Lubos
authors.forename: Raffi
authors.initials: R
authors.lastname: Bekeredjian
authors.forename: Taoufik
authors.initials: T
authors.lastname: Ouarrak
authors.forename: Björn
authors.initials: B
authors.lastname: Plicht
authors.forename: Holger
authors.initials: H
authors.lastname: Eggebrecht
authors.forename: Georg
authors.initials: G
authors.lastname: Nickenig
authors.forename: Christian
authors.initials: C
authors.lastname: Butter
authors.forename: Rainer
authors.initials: R
authors.lastname: Hoffmann
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hink
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery*; D006328:Cardiac Catheterization / Q000009:adverse effects; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000503:physiopathology*; D008944:Mitral Valve Insufficiency / Q000503:physiopathology* / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology; D012042:Registries; D016896:Treatment Outcome