Key result
MitraClip is linked to a ~56% reduction in nsVT or sVT at six months.
Why the study?
Patients with heart failure and severe MR have a poor prognosis and an increased risk for ventricular arrhythmias, but the impact of MitraClip repair on reducing these arrhythmias was unclear.
Does transcatheter mitral valve repair using MitraClip reduce ventricular arrhythmias in patients with heart failure and severe mitral regurgitation?
Observational (n=50)
Does transcatheter mitral valve repair using MitraClip reduce ventricular arrhythmias in patients with heart failure and severe mitral regurgitation?
Absolute Event Rate: 14% vs 32%
p-value: p=0.01
Transcatheter mitral valve repair using MitraClip is associated with a significant reduction in the prevalence of ventricular arrhythmias at 6 months in patients with severe mitral regurgitation.
May suggest arrhythmia benefit with MitraClip in severe MR; hypothesis-generating and requires randomized confirmation before practice change.
AIMS: Patients with heart failure and severe mitral regurgitation (MR) have a poor prognosis and carry an increased risk for ventricular arrhythmias. The present study evaluates the impact of transcatheter mitral valve repair using the MitraClip on the potential reduction of ventricular arrhythmias. METHODS AND RESULTS: Patients undergoing MitraClip implantation were prospectively enrolled into the present study and received 24 h Holter ECG assessment prior to and 6 months after the procedure. In addition, left ventricular dimensions and function were assessed at baseline and follow-up. A total of 50 patients with mainly functional MR (82%) were included. Non-sustained or sustained ventricular tachycardia (nsVT and/or sVT) occurred in 32% of patients and was reduced to 14% at follow-up (P = 0.01). Also, premature ventricular complex (PVC) burden ≥5% decreased from 16% to 4% (P = 0.04). Patients with persistent (n = 6) or new (n = 1) nsVT and/or sVT at follow-up showed a significant decrease in left ventricular ejection fraction from 38% (interquartile range 26-45%) to 33% (interquartile range 22-44%; P = 0.03). CONCLUSIONS: In this prospective study, transcatheter mitral valve repair using MitraClip was associated with a reduced prevalence of ventricular arrhythmias. The subset of patients with persistent or new ventricular arrhythmias after MitraClip implantation showed progression of left ventricular dysfunction.
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Ledwoch et al. (2019) conducted an observational in Heart failure and severe mitral regurgitation (n=50). Transcatheter mitral valve repair using MitraClip vs. Baseline (prior to procedure) was evaluated on Non-sustained or sustained ventricular tachycardia (nsVT and/or sVT) (p=0.01). Transcatheter mitral valve repair using MitraClip was associated with a reduction in non-sustained or sustained ventricular tachycardia from 32% at baseline to 14% at 6 months (P=0.01).
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