Atrial Fibrillation and Clinical Outcomes Following Mitral Transcatheter Edge-to-Edge Repair According to Mitral Regurgitation Etiology

BACKGROUND: The association between atrial fibrillation (AF) and prognosis after mitral transcatheter edge-to-edge repair (M-TEER) remains unclear. OBJECTIVES: The authors examined the association between AF and clinical outcomes after M-TEER according to the etiology of mitral regurgitation (MR). METHODS: A total of 3,764 patients were classified into degenerative mitral regurgitation (DMR), ventricular functional mitral regurgitation (VFMR), and atrial functional mitral regurgitation (AFMR). We further stratified the patients by the presence of AF. The primary outcome was all-cause mortality within 2 years. RESULTS: The prevalence of AF was 57.4% (n = 646 of 1,126) in DMR, 59.7% (n = 1,319 of 2,211) in VFMR, and 83.8% (n = 358 of 427) in AFMR. During 2-year follow-up (the median follow-up: 427 [IQR: 301-821] days), 660 of 3,764 patients (17.5%) died. The association between AF and all-cause mortality had a significant interaction with MR etiology (P for interaction