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Updated: Sep 17, 2025
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Published on: July 20, 2022
Relationship Between Left Atrial Coupling Index and Atrial High-Rate Episodes
Ayca Arslan1, Dogan Ilis1, Inanç Artac1
1Department of Cardiology, Kafkas University School of Medicine, Kars, Turkey.
Insights
The left atrial coupling index (LACI) is a better predictor of atrial high-rate episodes (AHREs) than traditional parameters like left atrial volume index (LAVI) in patients with cardiac implantable electronic devices (CIEDs). This finding aids in predicting AHRE progression to atrial fibrillation.
Area of Science:
- Cardiology
- Biomedical Engineering
- Echocardiography
Background:
- Atrial high-rate episodes (AHREs) can progress to atrial fibrillation, necessitating accurate prediction.
- Cardiac implantable electronic devices (CIEDs) are commonly used in patients with arrhythmias.
- Early identification of AHRE risk is crucial for patient management.
Purpose of the Study:
- To evaluate the predictive accuracy of the left atrial coupling index (LACI) for AHREs.
- To compare LACI's performance against established echocardiographic parameters.
- To identify novel predictors for AHRE in CIED patients.
Main Methods:
- Retrospective analysis of 203 CIED patients with available echocardiographic data.
- Comparison of echocardiographic parameters including LACI, left atrial volume index (LAVI), left ventricle end-diastolic diameter (LVEDD), and left ventricle ejection fraction (LVEF).
- Statistical analysis to determine independent predictors of AHRE and compare predictive accuracy using ROC curves.
Main Results:
- 42.8% of patients experienced AHRE.
- Higher LACI, LAVI, mitral E/Em, LVEDD, and lower LVEF were associated with AHRE.
- LACI, LAVI, and age were independent predictors of AHRE, with LACI demonstrating superior predictive ability over LAVI.
Conclusions:
- The left atrial coupling index (LACI) is a more robust and accessible echocardiographic predictor of AHRE compared to traditional parameters like LAVI.
- Accurate prediction of AHRE is vital due to its association with atrial fibrillation.
- LACI offers a valuable tool for risk stratification in CIED patients.
Objective:
This study aimed to explore the role and compare the accuracy of the left atrial coupling index (LACI) with other efficient traditional parameters for predicting atrial high-rate episodes (AHREs) in patients with cardiac implantable electronic devices (CIEDs).
Methods:
This retrospective study included 203 patients with CIEDs whose echocardiographic data were recorded at least 6 months ago. The study population was divided into two groups based on whether the patients had developed AHRE. Subsequently, patients in the two groups were compared in terms of echocardiographic measurements, including left atrial functions, LACI, left atrial volume index (LAVI), left ventricle end-diastolic diameter (LVEDD), and lower left ventricle ejection fraction (LVEF).
Results:
AHRE was observed in 42.8% (n = 87) of the 203 patients. Those with AHRE had a higher mean mitral E/Em, LAVI, LACI, LVEDD, and lower LVEF. LACI (OR: 1.752, 95% CI: 1.356-2.263; p < 0.001), LAVI, and age were found to be independent predictors of AHREs. A receiver operating characteristic (ROC) curve comparison demonstrated that the LACI was a better predictor of AHRE than the LAVI.
Conclusion:
AHRE often progresses to atrial fibrillation, which has unfavorable consequences; therefore, predicting AHRE becomes vital. LACI, an easily accessible echocardiographic parameter, is a more robust predictor of AHRE than traditional parameters such as LAVI.
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