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Catheter ablation of concomitant atrial fibrillation improves survival of patients undergoing transcatheter edge-to-edge mitral valve repair
Background: Atrial fibrillation (AF) is the most common concomitant disease in patients undergoing transcatheter edge-to-edge repair (TEER) for mitral regurgitation (MR) and detrimentally affects their outcome. While there is increasing evidence for prognostic improvement and safety of catheter a...
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| Những tác giả chính: | , , , , , , , , , , , , , , |
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| Định dạng: | Bài viết |
| Ngôn ngữ: | Tiếng Anh |
| Được phát hành: |
Philipps-Universität Marburg
2023
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| Những chủ đề: | |
| Truy cập trực tuyến: | Bài toàn văn PDF |
| Các nhãn: |
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| Tóm tắt: | Background: Atrial fibrillation (AF) is the most common concomitant disease in
patients undergoing transcatheter edge-to-edge repair (TEER) for mitral
regurgitation (MR) and detrimentally affects their outcome. While there is
increasing evidence for prognostic improvement and safety of catheter ablation
(CA) of AF in the overall cohort of heart failure patients, corresponding data in
TEER patients are lacking.
Objectives: To investigate the impact of treatment regimens for concomitant AF
on survival of TEER patients.
Methods: In a multicenter observational cohort study consecutive patients
successfully undergoing TEER were analyzed and survival of patients receiving
CA of concomitant AF was compared with that of patients on pharmacological
AF treatment and with that of patients without a history of AF, using propensity
score matching (PSM).
Results: A total of 821 patients were analyzed. Of these, 608 (74.1%) had
concomitant AF, of whom 48 patients received CA. Patients with CA in AF
showed significantly higher 3-year-survival after TEER compared to
PSM-patients on pharmacological AF treatment (75.5% [36/48] vs. 49.4% [166/
336], p = 0.009). The 3-year-survival after TEER of patients with concomitant AF
treated with CA was not significantly different from PSM-patients without AF
(75.5% [36/48] vs. 68.3% [98/144], p = 0.36).
Conclusions: CA of AF is superior to pharmacotherapy as it significantly improves
the survival of TEER patients in a PSM analysis. CA even offsets the prognostic
disadvantage of coexisting AF in TEER patients. Given the growing evidence of
prognostic benefits in the overall cohort of HF patients, our data point out the
importance of treating concomitant AF and support CA as an essential part of a
holistic management of TEER patients. |
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| Mô tả sách: | Gefördert durch den Open-Access-Publikationsfonds der UB Marburg. |
| DOI: | 10.3389/fcvm.2023.1229651 |