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The incidence and risk factors of atrial high-rate episodes in patients with a dual-chamber pacemaker

Son Khac Le Nguyen1, Dung Ngoc Kieu1, Phuong Le Uyen Tran1

  • 1Department of Arrhythmia Treatment Cho Ray Hospital Ho Chi Minh City Vietnam.

Journal of Arrhythmia
|October 17, 2024
PubMed

Insights

Predictors for atrial high-rate episodes (AHREs) in patients with cardiovascular implantable electronic devices were identified. History of paroxysmal supraventricular tachycardia and anti-arrhythmic drug use are key risk factors for developing AHREs.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Cardiovascular implantable electronic devices (CIEDs) can detect atrial high-rate episodes (AHREs).
  • Predictors for clinically relevant AHREs remain poorly understood.
  • Identifying these predictors is crucial for patient management and risk stratification.

Purpose of the Study:

  • To identify independent predictors of new-onset atrial high-rate episodes (AHREs) in patients with CIEDs.
  • To investigate the association between pre-implantation factors and AHRE development.
  • To enhance the understanding of risk factors for AHREs in a prospective cohort.

Main Methods:

  • Prospective study of 145 patients without atrial fibrillation (AF) undergoing CIED implantation.
  • AHREs defined as programmed atrial detection rate >190 beats per minute.
  • Multivariable Cox regression analysis to determine risk factors for AHREs over 6-month follow-up.

Main Results:

  • AHREs occurred in 30.3% of patients during the 6-month follow-up period.
  • Independent predictors identified included prior anti-arrhythmic drug (AAD) use (HR 7.71), history of paroxysmal supraventricular tachycardia (PSVT) (HR 2.45), percentage of premature atrial contractions (PACs) (HR 1.008), and left ventricular global longitudinal strain (GLS-LV) (HR 0.92).
  • Significant associations were found between these factors and the development of AHREs (p < .05).

Conclusions:

  • History of PSVT and prior AAD use are significant predictors of AHREs.
  • The percentage of PACs on Holter monitoring and GLS-LV are also independent predictors of new-onset AHREs.
  • These findings aid in identifying patients at higher risk for AHREs requiring CIED monitoring.
Abstract

Keywords:
atrial high‐rate episodes (AHRE)global longitudinal strain (GLS)subclinical atrial fibrillation

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