Atrial high-rate episodes: a comprehensive review

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Cardiac electronic implantable devices (CIEDs) detect atrial high-rate episodes (AHRE), a distinct arrhythmic entity.
• AHRE are atrial tachyarrhythmias, often considered precursors to atrial fibrillation (AF), but can also represent other supraventricular arrhythmias.
• While CIED-detected AHRE correlate with increased stroke risk, this risk is substantially lower than that of clinical AF.

Purpose of the Study:

• To review the epidemiology, predictive factors, clinical impact, and management strategies for AHRE.
• To address the challenges in managing AHRE due to current evidence gaps.

Main Methods:

• Literature review focusing on CIED-detected AHRE.
• Analysis of epidemiological data, risk factors, and clinical outcomes.
• Evaluation of current and proposed management guidelines.

Main Results:

• AHRE are increasingly recognized due to CIED monitoring capabilities.
• A temporal correlation between AHRE and thromboembolic events appears lacking.
• The clinical significance and optimal management of AHRE require further investigation.

Conclusions:

• AHRE represent a complex arrhythmia entity requiring careful consideration in clinical practice.
• Further research is essential to clarify the prognostic implications and refine management protocols for AHRE.
• Understanding AHRE is crucial for optimizing patient care and device management.