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Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable

Min Kim1, Tae Hoon Kim1, Hee Tae Yu1

  • 1Division of Cardiology, Yonsei University Health System, Seoul, Korea.

Korean Circulation Journal
|March 3, 2021
PubMed

Insights

Predictors of clinically relevant atrial high-rate episodes (AHREs) were identified. Larger left atrium diameter and sick sinus syndrome predict AHREs >6 minutes in patients with cardiovascular implantable electronic devices (CIEDs).

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Atrial high-rate episodes (AHREs) are detectable by cardiovascular implantable electronic devices (CIEDs).
  • Predictors for clinically significant AHREs remain unclear.
  • Understanding these predictors is crucial for patient management.

Purpose of the Study:

  • To identify predictors of clinically relevant atrial high-rate episodes (AHREs) detected by CIEDs.
  • To differentiate between transient and sustained AHREs.
  • To assess the association of patient characteristics with AHREs duration.

Main Methods:

  • Prospective multicenter study of 816 patients without atrial fibrillation (AF) monitored via CIEDs.
  • AHREs defined as atrial detection rate >220 beats/min.
  • Analysis focused on AHREs durations of >6 minutes and >6 hours, with clinical AF documentation.

Main Results:

  • AHREs >6 minutes occurred in 13.7% of patients.
  • Patients with AHREs >6 minutes had larger left atrium (LA) size and higher prevalence of sick sinus syndrome.
  • Multivariable analysis identified LA diameter >41 mm (OR 2.08) and sick sinus syndrome (OR 3.22) as significant predictors of AHREs >6 minutes.

Conclusions:

  • Left atrium diameter >41 mm and sick sinus syndrome are associated with an increased risk of developing AHREs >6 minutes.
  • These findings aid in stratifying risk for clinically relevant AHREs in patients with CIEDs.
  • Further research may refine management strategies based on these predictors.
Abstract

Keywords:
ArrhythmiaLeft atriumPacemaker, artificialSick sinus syndrome

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