A-Fib Linked to Worse Outcomes for Patients With Heart Failure, MR Undergoing Valve Repair
By Elana Gotkine HealthDay Reporter
THURSDAY, July 24, 2025 -- For patients with heart failure and severe mitral regurgitation (MR) undergoing transcatheter edge-to-edge repair (M-TEER), baseline atrial fibrillation (AF) is associated with more frequent MR recurrence and an increased risk for death or heart failure hospitalization (HFH), according to a study published online July 17 in the Journal of the American Heart Association.
Carlo Mannina, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues examined the impact of baseline AF in patients with severe MR undergoing M-TEER in a study involving 156 patients with symptomatic heart failure. The composite outcome of death or HFH was the primary end point.
MR etiology was primary and secondary in 44.2 and 55.8 percent of patients, respectively. Overall, 37.8 percent of patients had AF or atrial flutter at baseline. The researchers found that M-TEER was successful in 98.3 and 96.9 percent of 59 and 97 patients with and without AF, respectively. The primary end point occurred in 64 patients during a median follow-up of 12.5 months, including death and HFH in 16 and 57 patients (10.3 and 36.5 percent), respectively. Baseline AF was a significant independent predictor of death or HFH (adjusted hazard ratio, 2.03). Among patients in sinus rhythm but not those in AF, left ventricular end-diastolic volume, left atrial volume, and right ventricular systolic pressure decreased during follow-up. There was an association for AF with an increased risk for severe MR recurrence (18.6 versus 8.2 percent).
"These findings support early treatment of heart failure and mitral regurgitation before atrial fibrillation develops, in addition to considering ablation should atrial fibrillation occur," coauthor Gregg W. Stone, M.D., also from the Icahn School of Medicine, said in a statement.
Several authors disclosed ties to the pharmaceutical and medical device industries.
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.
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Posted July 2025
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