• Ching-Wei Lee, Christian Frerker, Wei-Ming Huang, Yi-Lin Tsai, Chi-Jung Huang, Wen-Chung Yu, Chiao-Po Hsu, Chern-En Chiang, Chen-Huan Chen, and Shih-Hsien Sung.
• Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
• Eur. J. Clin. Invest. 2020 Oct 1; 50 (10): e13274.

AimsAtrial fibrillation (AF) is a frequent comorbidity among patients with severe mitral regurgitation (MR). Direct current (DC) cardioversion is one of the strategies for rhythm control. However, the safety and feasibility of immediate DC cardioversion after MitraClip are not elucidated.Methods And ResultsIn this study, patients with symptomatic severe MR who underwent MitraClip were included. After fixing the MR, synchronized DC cardioversion was attempted for those with AF. A total of consecutive 60 patients, 36 subjects (60%), comorbid with AF. DC cardioversion was performed in 30 patients (mean age of 76.0 ± 9.3 years), and the successful conversion was achieved in 15 patients (50%). There was no any adverse event related to the cardioversion. Subjects with sustained conversion to SR experienced significant improvement in 6MWT (failed: 285 ± 110-308 ± 135 m, P = .278; successful: 269 ± 109 m-328 ± 78, P = .047) and reduction in NT-proBNP level (failed: 4411 ± 7401-3296 ± 4299 ng/mL, P = .217; successful: 4094 ± 2735-2353 ± 2856 ng/mL, P = .026) at 1 month.ConclusionsDirect current cardioversion seemed to be safe and feasible immediately after the transcatheter edge-to-edge mitral valve repairs. Subjects who maintain SR experienced better functional improvement.© 2020 Stichting European Society for Clinical Investigation Journal Foundation.

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