Study emphasizes the importance of controlling heart rhythm before mitral transcatheter edge-to-edge repair

Medical Xpress / The Mount Sinai Hospital / Journal of the American Heart Association ^ | July 17, 2025 | Stamatios Lerakis, MD, Ph.D et al

[ConservativeMind]

Patients with heart failure and atrial fibrillation (AF) at the time of mitral transcatheter edge-to-edge repair (M-TEER) for severe mitral regurgitation are more than twice as likely to die or be rehospitalized for heart failure, compared to patients without AF.

These are the findings from a study that suggest that AF may have to be treated more aggressively before patients undergo this type of transcatheter procedure in order to improve outcomes.

Mitral regurgitation develops when the mitral valve, which controls the flow of blood from the left atrium into the left ventricle, becomes distorted from the enlarged left ventricle so that its leaflets do not completely close. This causes blood to leak backward, increases pressure in the heart, and puts patients at increased risk of hospitalization and death.

In most patients, this condition can be treated with a minimally invasive procedure called M-TEER in which the leaflets of the mitral valve are clipped together.

Atrial fibrillation—a rapid and irregular heartbeat—is found in up to one-third of patients with mitral regurgitation.

They analyzed 156 patients with symptomatic heart failure and severe mitral regurgitation treated with M-TEER.

M-TEER was equally successful in both groups (AF and no AF). However, those with AF fared worse in the months following: they were more likely to experience a return of valve leakage and their hearts didn't recover as well.

More specifically, within two years following the procedure, more than 52% of AF patients were either rehospitalized for heart failure or had died, compared to 33% of patients with no AF. Their hearts didn't recover as well—they showed no improvement in heart size and, additionally, severe valve leakage returned in 19% of AF patients versus 8% of patients without AF.

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TOPICS: Health/Medicine
KEYWORDS:

[ConservativeMind]

Treating the atrial fibrillation to control it before the mitral transcatheter edge-to-edge repair minimized all sorts of later issues.

Your doctor probably hasn’t read this, yet.

[ConservativeMind]

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[Qiviut]

Timely article - I have a relative with a leaky mitral valve & AF who will likely have to have a repair at some point. I’ll pass this on to her.

[Red Badger]

https://www.youtube.com/watch?v=mM-K2xVFyk0

[Crusher138]

Just had cardiac ablation to treat my persistent AFib. I basically had AFib all the time. After the procedure my AFib is 100% gone.