Po-02-203 impact of mitraclip implantation on the burden of atrial fibrillation

Patients presenting for valve repair for mitral regurgitation (MR) have a 30-40% prevalence of atrial fibrillation (AF). AF and MR share an intricate bidirectional relationship. With the increasing use of MitraClip in contemporary practice, data on its impact on AF burden remains lacking. To study the impact of MitraClip implantation on AF burden using implanted device interrogation data. We performed a single center, retrospective analysis of all patients undergoing MitraClip implantation between, 4/2014 and 3/2022 (n=289). Of these, 60 patients (36%; 33 pacemakers, 27 defibrillators) had pre-existing implanted devices. Amongst these, 15 patients had interrogation data available within 6 months prior, and 12 months after MitraClip implantation - they were included for final analysis. Wilcoxon sum rank test was performed for comparison of variables. A total of 15 patients were included in the final analysis (mean age 76 ±12), with a male predominance (66%) and mean LVEF of 35%. Pre-existing AF was reported in 73% of patients with an AF burden (mean-IQR) of 39.9±48%, pre-MitraClip. A substantial, halving of AF burden to 16.2±34% was observed post-MitraClip (p=0.1). A similar decline in the prevalence of persistent AF from 40% to 20% was noted post-MitraClip. MitraClip implantation is associated with a substantial reduction in AF burden as well as rates of persistent AF. Larger studies are required to further analyze this association.