{"id":8235,"date":"2025-08-05T21:47:41","date_gmt":"2025-08-05T18:47:41","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=8235"},"modified":"2025-08-05T21:47:41","modified_gmt":"2025-08-05T18:47:41","slug":"diabetes-and-obesity-and-treatment-effect-of-early-rhythm-control-vs-usual-care-in-patients-with-atrial-fibrillation-but-is-ablation-always-first","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/diabetes-and-obesity-and-treatment-effect-of-early-rhythm-control-vs-usual-care-in-patients-with-atrial-fibrillation-but-is-ablation-always-first\/","title":{"rendered":"Diabetes and Obesity and Treatment Effect of Early Rhythm Control vs Usual Care in Patients With Atrial Fibrillation\u2013 But Is Ablation Always First?"},"content":{"rendered":"
Diabetes and Obesity and Treatment Effect of Early Rhythm Control vs Usual Care in Patients With Atrial Fibrillation\u2013 But Is Ablation Always First?<\/div>\n
<\/div>\n
JAMA Cardiology, Published online July 30, 2025<\/div>\n
<\/div>\n
Summary:<\/div>\n
<\/div>\n
A new analysis based on the EAST-AFNET 4 randomized trial, published in JAMA Cardiology, confirms that early rhythm control (ERC) remains safe and effective for atrial fibrillation (AFib) patients \u2014 even in those with obesity or diabetes, two of the most common metabolic comorbidities.<\/div>\n
<\/div>\n
Key findings:<\/div>\n
1. Early rhythm control (ERC) therapy includes early use of antiarrhythmic drugs, ablation, or cardioversion.<\/span><\/div>\n
2. The analysis included:<\/span><\/div>\n
\u2022 Over 1,000 patients with obesity<\/span><\/div>\n
\u2022 Nearly 700 patients with diabetes<\/span><\/div>\n
3. Neither obesity nor diabetes reduced the \u2026<\/span><\/div>\n
[7:08 pm, 05\/08\/2025] Dr Jamal Aldabbas Card Socity: Edge-to-edge repair (TEER) \u201cPascal System\u201d\u00a0 Shows Benefits in Mitral and Tricuspid Valve Repair \u2013 1-Year Results from MiCLASP and TriCLASP Trials<\/div>\n
<\/div>\n
The studies were published in EuroIntervention in 2025, as highlighted by medical news sources on August 4, 2025.<\/div>\n
<\/div>\n
1. What Is the Pascal System?<\/div>\n
\u2022 A transcatheter edge-to-edge repair (TEER) system developed by Edwards Lifesciences.<\/span><\/div>\n
\u2022 Used for mitral (M-TEER) and tricuspid (T-TEER) valve repair.<\/span><\/div>\n
\u2022 Approved in Europe for both M-TEER and T-TEER.<\/span><\/div>\n
\u2022 Approved in the U.S. by the FDA for M-TEER only (not yet for tricuspid).<\/span><\/div>\n
<\/div>\n
2. MiCLASP Study \u2013 Mitral Valve (M-TEER) in Moderate Functional MR<\/div>\n
\u2022 Patients: 101 with moderate functional mitral regurgitation (FMR, grade 2+)<\/span><\/div>\n
\u2022 Results at 1 year:<\/span><\/div>\n
\u2022 89.8% had sustained MR reduction<\/span><\/div>\n
\u2022 Significant improvement in quality of life and functional capacity<\/span><\/div>\n
\u2022 Major Adverse Events (MAE): 13.9%<\/span><\/div>\n
\u2022\u00a0 \u00a0Conclusion: Even moderate symptomatic FMR patients may benefit from M-TEER using the Pascal system, despite current guidelines not recommending it for this group.<\/span><\/div>\n
<\/div>\n
3. TriCLASP Study \u2013 Tricuspid Valve (T-TEER)<\/div>\n
\u2022 Patients: 300 with mostly severe tricuspid regurgitation (TR)<\/span><\/div>\n
\u2022 Demographics: Average age 80.1 years; 52% women<\/span><\/div>\n
\u2022 Results:<\/span><\/div>\n
\u2022 87.7% achieved at least moderate TR reduction<\/span><\/div>\n
\u2022 MAE rates: 1.7% at 30 days; 12.7% at 1 year<\/span><\/div>\n
\u2022 Improved:<\/span><\/div>\n
\u2022 NYHA class<\/span><\/div>\n
\u2022 Quality of life (KCCQ score)<\/span><\/div>\n
\u2022 6-minute walk distance<\/span><\/div>\n
\u2022 \ud83d\udd0e Conclusion: The Pascal system was safe and effective for T-TEER in a real-world elderly population.<\/span><\/div>\n
<\/div>\n
4. Overall Insight<\/div>\n
\u2022 These findings support the expanded clinical use of the Pascal Precision system in earlier-stage mitral disease and in high-risk tricuspid valve patients.<\/span><\/div>\n
\u2022 Both studies were sponsored by Edwards Lifesciences and published in EuroIntervention.<\/span><\/div>\n
<\/div>\n
5.\u00a0 According to the original studies published in JAMA and EuroIntervention, and based on current FDA and CE mark approvals:<\/div>\n
<\/div>\n
The Pascal system is FDA-approved for use in patients with symptomatic severe primary or secondary mitral regurgitation (MR) who are not suitable for surgery.<\/div>\n
<\/div>\n
This highlights its established role in treating severe MR, while emerging data\u2014such as from the MiCLASP study\u2014suggests potential safe use in earlier stages like moderate FMR, though this is not yet guideline-endorsed.<\/div>\n
<\/div>\n
6.\u00a0 Although current guidelines prioritize T-TEER for patients with severe tricuspid regurgitation, emerging data from trials like TriCLASP suggest that selected patients with symptomatic moderate TR may also benefit from early transcatheter intervention.<\/div>\n
<\/div>\n
https:\/\/eurointervention.pcronline.com\/article\/transcatheter-mitral-repair-in-patients-with-symptomatic-moderate-functional-mitral-regurgitation-1-year-outcomes-from-the-miclasp-study<\/div>\n
<\/div>\n
https:\/\/eurointervention.pcronline.com\/article\/transcatheter-valve-repair-of-tricuspid-regurgitation-1-year<\/a><\/div>\n
<\/div>\n","protected":false},"excerpt":{"rendered":"

Diabetes and Obesity and Treatment Effect of Early Rhythm Control vs Usual Care in Patients With Atrial Fibrillation\u2013 But Is Ablation Always First? JAMA Cardiology, Published online July 30, 2025 Summary: A new analysis based on the EAST-AFNET 4 randomized trial, published in JAMA Cardiology, confirms that early rhythm control (ERC) remains safe and effective […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8235","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8235","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=8235"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8235\/revisions"}],"predecessor-version":[{"id":8236,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8235\/revisions\/8236"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=8235"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=8235"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=8235"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}