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Novel Predictor for New-Onset Atrial High-Rate Episode in Patients With a Dual-Chamber Pacemaker

Ryo Nishinarita1, Shinichi Niwano1, Jun Oikawa1

  • 1Department of Cardiovascular Medicine, Kitasato University School of Medicine Sagamihara Japan.

Circulation Reports
|September 27, 2021
PubMed

Insights

P-wave dispersion (PWD) predicts new-onset atrial high-rate episodes (AHRE) in patients with cardiac implantable electronic devices (CIEDs). Longer PWD indicates a higher risk, suggesting PWD is a feasible predictor for AHRE in CIED patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Atrial high-rate episodes (AHRE) are more common in patients with cardiac implantable electronic devices (CIEDs).
  • Predictors for new-onset AHRE in CIED patients require further elucidation.
  • P-wave dispersion (PWD) in sinus rhythm is a potential marker for atrial electrical instability.

Purpose of the Study:

  • To identify clinical factors associated with new-onset AHRE in CIED patients.
  • To investigate the predictive value of PWD for AHRE in this population.
  • To establish a potential cut-off value for PWD to identify at-risk individuals.

Main Methods:

  • A cohort of 101 patients with newly implanted CIEDs was studied.
  • P-wave dispersion (PWD) was measured using body-surface electrocardiography at implantation.
  • Patients were categorized into AHRE and non-AHRE groups based on device data within one year.

Main Results:

  • The AHRE group (n=34) exhibited significantly longer PWD compared to the non-AHRE group (n=67) (62.6±13.1 ms vs. 38.2±13.9 ms).
  • Multivariate analysis identified PWD as an independent predictor of new-onset AHRE (OR 1.11, P<0.0001).
  • Receiver-operating characteristic analysis indicated an optimal PWD cut-off of 48 mm for predicting AHRE (AUC 0.90).

Conclusions:

  • P-wave dispersion is a simple and feasible predictor of new-onset AHRE in patients with CIEDs.
  • Elevated PWD may identify patients at higher risk for developing AHRE after CIED implantation.
  • PWD measurement offers a valuable tool for risk stratification in CIED patients.

Keywords:
Atrial fibrillationAtrial high-rate episodeCardiac implantable electronic deviceP-wave dispersion

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