Ventricular arrhythmias in patients with functional mitral regurgitation and implantable cardiac devices: implications of mitral valve repair with Mitraclip
MitraClip®
functional mitral regurgitation (FMR)
heart failure with reduced ejection fraction
implantable cardiac devices
ventricular arrhythmias
Journal
Annals of translational medicine
ISSN: 2305-5839
Titre abrégé: Ann Transl Med
Pays: China
ID NLM: 101617978
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
entrez:
21
9
2020
pubmed:
22
9
2020
medline:
22
9
2020
Statut:
ppublish
Résumé
Limited information has been reported regarding the impact of percutaneous mitral valve repair (PMVR) on ventricular arrhythmic (VA) burden. The aim of this study was to address the incidence of VA and appropriate antitachycardia implantable cardiac defibrillator (ICD) therapies before and after PMVR. We retrospectively analyzed all consecutive patients with heart failure with reduce left ventricular ejection fraction (LVEF), functional mitral regurgitation (FMR) grade 3+ or 4+ and an active ICD or cardiac resynchronizer who underwent PMVR in any of the eleven recruiting centers. Only patients with complete available device VA monitoring from one-year before to one year after PMVR were included. Baseline clinical and echocardiographic characteristics were collected before PMVR and at 12-months follow-up. Ninety-three patients (68.2±10.9 years old, male 88.2%) were enrolled. PMVR was successfully performed in all patients and device success at discharge was 91.4%. At 12-month follow-up, we observed a significant reduction in mitral regurgitation severity, NT-proBNP and prevalence of severe pulmonary hypertension and severe kidney disease. Patients also referred a significant improvement in NYHA functional class and showed a non-significant trend to reserve left ventricular remodeling. After PMVR a significant decrease in the incidence of non-sustained ventricular tachycardia (VT) (5.0±17.8 PMVR was related to a reduction in arrhythmic burden and ICD therapies in our cohort.
Sections du résumé
BACKGROUND
BACKGROUND
Limited information has been reported regarding the impact of percutaneous mitral valve repair (PMVR) on ventricular arrhythmic (VA) burden. The aim of this study was to address the incidence of VA and appropriate antitachycardia implantable cardiac defibrillator (ICD) therapies before and after PMVR.
METHODS
METHODS
We retrospectively analyzed all consecutive patients with heart failure with reduce left ventricular ejection fraction (LVEF), functional mitral regurgitation (FMR) grade 3+ or 4+ and an active ICD or cardiac resynchronizer who underwent PMVR in any of the eleven recruiting centers. Only patients with complete available device VA monitoring from one-year before to one year after PMVR were included. Baseline clinical and echocardiographic characteristics were collected before PMVR and at 12-months follow-up.
RESULTS
RESULTS
Ninety-three patients (68.2±10.9 years old, male 88.2%) were enrolled. PMVR was successfully performed in all patients and device success at discharge was 91.4%. At 12-month follow-up, we observed a significant reduction in mitral regurgitation severity, NT-proBNP and prevalence of severe pulmonary hypertension and severe kidney disease. Patients also referred a significant improvement in NYHA functional class and showed a non-significant trend to reserve left ventricular remodeling. After PMVR a significant decrease in the incidence of non-sustained ventricular tachycardia (VT) (5.0±17.8
CONCLUSIONS
CONCLUSIONS
PMVR was related to a reduction in arrhythmic burden and ICD therapies in our cohort.
Identifiants
pubmed: 32953756
doi: 10.21037/atm.2020.02.45
pii: atm-08-15-956
pmc: PMC7475388
doi:
Types de publication
Journal Article
Langues
eng
Pagination
956Informations de copyright
2020 Annals of Translational Medicine. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm.2020.02.45). The series “Structural Heart Disease: The Revolution” was commissioned by the editorial office without any funding or sponsorship. REL, CG, XF and LNF are consultants for Abbott vascular and proctor for MitraClip®. MT is consultant for Abbott Vascular, Boston Scientific, 4tech, CoreMedic. Speaker fees from Edwards Lifesciences. The authors have no other conflicts of interest to declare.
Références
N Engl J Med. 2018 Dec 13;379(24):2297-2306
pubmed: 30145927
Europace. 2010 Oct;12(10):1439-45
pubmed: 20817721
Int J Cardiol. 2011 Feb 3;146(3):426-8
pubmed: 21094544
Eur Heart J Cardiovasc Imaging. 2015 Mar;16(3):233-70
pubmed: 25712077
Lancet. 2009 Apr 18;373(9672):1382-94
pubmed: 19356795
Heart Rhythm. 2014 Jul;11(7):1109-16
pubmed: 24837348
J Am Coll Cardiol. 2019 Dec 17;74(24):2969-2979
pubmed: 31574303
Circulation. 2006 Dec 19;114(25):2766-72
pubmed: 17159063
Eur J Heart Fail. 2018 Nov;20(11):1505-1535
pubmed: 29806100
Eur J Heart Fail. 2018 Mar;20(3):525-532
pubmed: 29266564
Cardiovasc Revasc Med. 2020 Jan;21(1):52-60
pubmed: 31326258
J Am Coll Cardiol. 2005 Dec 20;46(12):2258-63
pubmed: 16360055
J Am Coll Cardiol. 2017 Apr 11;69(14):1842-1860
pubmed: 28385314
Am J Cardiol. 2018 Jun 15;121(12):1601-1609
pubmed: 29678335
Am J Cardiol. 2019 Oct 1;124(7):1113-1119
pubmed: 31376913
N Engl J Med. 2018 Dec 13;379(24):2307-2318
pubmed: 30280640
ESC Heart Fail. 2018 Oct;5(5):892-901
pubmed: 30058757
Circulation. 2001 Apr 3;103(13):1759-64
pubmed: 11282907
J Thorac Cardiovasc Surg. 2005 Dec;130(6):1542-8
pubmed: 16307996
Eur J Heart Fail. 2008 Oct;10(10):1007-14
pubmed: 18692437
J Am Coll Cardiol. 2018 Aug 14;72(7):738-750
pubmed: 30092950
Europace. 2019 Sep 1;21(9):1385-1391
pubmed: 31505617
Int J Cardiol. 2017 Feb 1;228:191-197
pubmed: 27875721
Pacing Clin Electrophysiol. 2009 Mar;32(3):314-22
pubmed: 19272060
Cardiol Rev. 2019 May/Jun;27(3):160-166
pubmed: 30052536
J Am Coll Cardiol. 2018 Aug 21;72(8):823-834
pubmed: 30115220
Circ J. 2018 Oct 25;82(11):2800-2810
pubmed: 30210070
Eur J Heart Fail. 2013 Jul;15(7):808-17
pubmed: 23537547
Cardiol Clin. 2014 Feb;32(1):125-33, ix
pubmed: 24286583
Circ Cardiovasc Interv. 2015 Jan;8(1):
pubmed: 25593120
J Am Coll Cardiol. 2015 Jul 21;66(3):308-321
pubmed: 26184623
Eur Heart J Cardiovasc Imaging. 2013 Jul;14(7):611-44
pubmed: 23733442