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The Association Between Significant Mitral Regurgitation and Atrial Fibrillation Recurrence Post-Ablation.
Arni Gershman1,2, Rivka Farkash3, Amjad Abu-Salman3,4
1Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem 9112001, Israel.
Journal of Clinical Medicine
|October 29, 2025
Summary
Significant mitral regurgitation (MR) increases atrial fibrillation (AF) recurrence after ablation. This study found moderate-severe or severe MR independently predicts AF recurrence, highlighting MR
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Surgery
Background:
- Atrial fibrillation (AF) is a prevalent tachyarrhythmia linked to increased morbidity.
- AF often coexists with mitral regurgitation (MR), with MR severity impacting AF but its effect on post-ablation recurrence remaining unclear.
Purpose of the Study:
- To investigate the association between pre-ablation mitral regurgitation (MR) severity and atrial fibrillation (AF) recurrence following catheter ablation.
- To determine if significant MR independently predicts AF recurrence post-ablation.
Main Methods:
- Retrospective analysis of 444 patients undergoing AF catheter ablation from 2014-2024.
- Pre-procedural echocardiograms assessed baseline MR severity; 'significant' MR (moderate-severe/severe) was compared to 'non-significant' MR.
- Inverse probability treatment weighting (IPTW) adjusted analyses assessed the association between MR and AF recurrence.
Main Results:
- Among 444 patients, 6.3% had significant baseline MR. AF recurrence occurred in 23.4% over a median 19-month follow-up.
- IPTW-adjusted analysis revealed a robust association between significant MR and AF recurrence (HR=2.41, p<0.001).
- Multivariable analysis on IPTW-adjusted data confirmed significant MR as an independent predictor of AF recurrence (HR=2.11, p=0.003).
Conclusions:
- Pre-ablation mitral regurgitation severity is significantly associated with atrial fibrillation recurrence post-ablation.
- This association persists independently of other clinical factors and warrants further investigation in larger cohorts.
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