• Alexander Jabs, Ralph S von Bardeleben, Peter Boekstegers, Miriam Puls, Edith Lubos, Raffi Bekeredjian, Taoufik Ouarrak, Björn Plicht, Holger Eggebrecht, Georg Nickenig, Christian Butter, Rainer Hoffmann, Jochen Senges, and Ulrich Hink.
• Zentrum für Kardiologie, Kardiologie 1, Universitätsmedizin Mainz, Mainz, Germany.
• EuroIntervention. 2017 Feb 20; 12 (14): 1697-1705.

AimsIn 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 ResultsSeven 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.ConclusionsThese 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.

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