Background Little is known regarding the impact of right ventricular (RV) function on clinical outcomes following MitraClip therapy. Objectives The aim of this study was to investigate the prognostic impact of RV dysfunction and its cut-off value following MitraClip therapy. Methods Consecutive 77 patients (median 79 years, 33% female) who underwent MitraClip therapy were enrolled. Clinical endpoint was defined as cardiovascular (CV) events, including cardiovascular death and rehospitalization for heart failure (HF). Results and conclusions Twenty-two (29%) patients had primary mitral regurgitation (MR). During follow-up, 5 patients died due to CV events, 8 were hospitalized for HF. On univariate Cox regression analysis, CV events were associated with eGFR (HR; 0.960, 95% CI; 0.926–0.995, p = 0.027), tricuspid annular plane systolic excursion (TAPSE, HR; 0.874, 95% CI; 0.789–0.968, p = 0.010), and significant residual MR (HR; 11.652, 95% CI; 3.257–41.691, p <0.001). On multivariate Cox regression analysis, TAPSE (HR; 0.788, 95% CI; 0.788–0.987, p = 0.029) and significant residual MR (HR; 9.373, 95% CI; 2.581–34.033, p = 0.001) were independently associated with CV events. TAPSE <11 mm was the best cut-off criteria for predicting CV events. RV function was independently associated with clinical outcomes following MitraClip therapy. TAPSE is a simple parameter for predicting CV events in patients with MR who are undergoing MitraClip therapy.

Introduction: The impact of catheter ablation for atrial fibrillation (AF) on cardiovascular events and mortality is controversial. We investigated the impact of sinus rhythm maintenance on major adverse cardiac and cerebrovascular events after AF ablation from a Japanese multicenter cohort of AF ablation. Methods and Results: We investigated 2737 consecutive patients (25.6% female, mean age 63.4 ± 10.3 years) who underwent a first catheter ablation for AF from the Atrial Fibrillation registry to Follow the long-teRm Outcomes and use of aNTIcoagulants aftER Ablation (AF Frontier Ablation Registry). The primary endpoint was a composite of stroke, transient ischemic attack, cardiovascular events, and all-cause death. During a mean follow-up of 25.2 months, 2070 (75.6%) patients were free from AF after catheter ablation, and the primary composite endpoint occurred in 122 (4.5%) patients. The AF nonrecurrence group had a significantly lower incidence of the primary endpoint (1.7 per 100 person-years) compared with the AF recurrence group (3.2 per 100 person-years; P = 0.001). The multivariate analysis revealed that freedom from AF (hazard ratio 0.57; 95% confidence interval 0.39–0.83; P = 0.003) was independently associated with the incidence of the composite event.¬¬ Conclusion: In the multicenter cohort of AF ablation, sinus rhythm maintenance after catheter ablation was independently associated with lower rates of major adverse cardiac and cerebrovascular events.