Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices: Dynamic Changes in Episodes and Predictors of Incident Atrial Fibrillation

Background. Atrial high rate episodes (AHRE) detected by cardiac implantable electronic devices (CIEDs) may be associated with a risk of progression towards long-lasting episodes (≥24 h) and clinical atrial fibrillation (AF). Methods. Consecutive CIED patients presenting AHRE (with confirmation of a...

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Published in:Biology (Basel, Switzerland) Vol. 11; no. 3; p. 443
Main Authors: Imberti, Jacopo Francesco, Bonini, Niccolò, Tosetti, Alberto, Mei, Davide Antonio, Gerra, Luigi, Malavasi, Vincenzo Livio, Mazza, Andrea, Lip, Gregory Y. H., Boriani, Giuseppe
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 15.03.2022
MDPI
Subjects:
Age
AHRE
Arrhythmia
Asymptomatic
atrial fibrillation
atrial high-rate episodes
Cardiac arrhythmia
cardiac implantable electronic devices
Decision making
EKG
Electronic equipment
females
Fibrillation
hazard ratio
Heart rate
Multivariate analysis
pacemaker
Patients
risk
Stroke
subclinical atrial fibrillation
Thromboembolism
Variables
atrial fibrillation
cardiac implantable electronic devices
pacemaker
AHRE
atrial high-rate episodes
subclinical atrial fibrillation
defibrillators
ISSN:2079-7737, 2079-7737
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Summary:Background. Atrial high rate episodes (AHRE) detected by cardiac implantable electronic devices (CIEDs) may be associated with a risk of progression towards long-lasting episodes (≥24 h) and clinical atrial fibrillation (AF). Methods. Consecutive CIED patients presenting AHRE (with confirmation of an arrhythmia lasting 5 min–23 h 59 min, atrial rate ≥175/min, with no AF at 12-lead ECG and no prior clinical AF) were retrospectively enrolled. The aims of this study were to describe patients’ characteristics and the incidence of adverse events, and second, to identify potential predictors of the composite outcome of clinical AF and/or AHRE episodes lasting ≥24 h. Results. 104/107 (97.2%) patients (median age 79.7 (74.0–84.2), 33.7% female) had available follow-up data. Over a median follow-up of 24.3 (10.6–40.3) months, 31/104 (29.8%) patients experienced the composite outcome of clinical AF or AHRE episodes lasting ≥24 h. Baseline CHA2DS2-VASc score and the longest AHRE episode at enrollment lasting 12 h–23 h 59 min were independently associated with the composite outcome (Hazard ratio (HR); 95% CI: 1.40; 1.07–1.83 and HR: 8.15; 95% CI 2.32–28.65, respectively). Baseline CHA2DS2-VASc score and the longest AHRE episode at enrollment lasting 12 h–23 h 59 min were the only independent predictors of incident clinical AF (HR: 1.45; 95% CI 1.06–2.00 and HR: 4.25; 95% CI 1.05–17.20, respectively). Conclusions. In patients with AHRE, the incidence of clinical AF or AHRE episodes lasting ≥24 h is high in a two-year follow-up. Baseline patients’ characteristics (CHA2DS2-VASc score) and AHRE duration may help to intensify monitoring and decision-making, being independently associated with clinical AF at follow-up.
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ISSN:2079-7737
2079-7737
DOI:10.3390/biology11030443