Relationship Between Left Atrial Coupling Index and Atrial High-Rate Episodes

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.