Key result
Atrial high-rate episodes detected by cardiac electronic implantable devices are associated with an increased risk of stroke, though significantly lower than the stroke risk of clinical atrial fibrillation.
Why the study?
Appropriate management of device-detected atrial high-rate episodes is challenging because of current gaps in evidence regarding their clinical impact and thromboembolic risk.
AHRE detected by CIEDs increase thromboembolic risk compared to no AHRE, but less than clinical AF, and management requires individualized assessment of stroke risk and AF burden.
Cardiac electronic implantable devices (CIEDs) have the ability to monitor, store and interpret complex arrhythmias, which has generated a new arrhythmic entity: atrial high-rate episodes (AHRE). AHRE are atrial tachyarrhythmias, detected only by CIEDs. They are widely considered a precursor to atrial fibrillation (AF) but can also be represented by other kinds of supraventricular arrhythmias such as atrial flutter or atrial tachycardia. CIED-detected AHRE are associated with an increased risk of stroke, but the risk is significantly lower than the stroke risk of clinical AF. Moreover, there seems to be no temporal correlation between AHRE and thromboembolic events. Because of the current gaps in evidence, the appropriate management of this arrythmia can be challenging. In this review we take into account the epidemiology behind AHRE, predictive factors, clinical impact and management of this arrhythmia.
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Simu et al. (2021) conducted a review in Atrial high-rate episodes (AHRE). Atrial high-rate episodes detected by cardiac electronic implantable devices are associated with an increased risk of stroke, though significantly lower than the stroke risk of clinical atrial fibrillation.
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