October 4, 2016EP Europace104 citationsOpen Access
Atrial high-rate episodes and stroke prevention
View Full Paper
Key Result
Oral anticoagulation for stroke prevention in patients with atrial high-rate episodes (AHRE) is currently being evaluated in clinical trials, as their prognostic significance remains unclear.
Key Points
- The aim is to explore whether oral anticoagulation is necessary for patients with atrial high-rate episodes.
- Clinical trials of oral anticoagulant therapy are underway.
- Participants include patients with atrial high-rate episodes recorded on implantable devices.
- Focus on assessing stroke risk in patients without clinically diagnosed atrial fibrillation.
- Patients with AHRE have a higher likelihood of subsequent strokes compared to those without.
- Stroke rates in AHRE patients are lower than those seen in patients diagnosed with AF.
- The significance and implications of short atrial tachyarrhythmia episodes remain unclear.
Structured PICO
Do oral anticoagulants prevent stroke in patients with atrial high-rate episodes (AHRE) lasting at least 6 minutes without clinically diagnosed atrial fibrillation?
P
Population
Patients with atrial high-rate episodes (AHRE) recorded on a cardiac implantable electronic device, lasting for at least 6 min in the absence of clinically diagnosed atrial fibrillation
I
Intervention
Oral anticoagulants (OACs)
O
Outcome
Strokehard clinical
The benefit of oral anticoagulation for stroke prevention in patients with device-detected atrial high-rate episodes without clinical AF remains uncertain, pending the results of ongoing clinical trials.
Abstract
While the benefit of oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation (AF) is well established, it is not known whether oral anticoagulation is indicated in patients with atrial high-rate episodes (AHRE) recorded on a cardiac implantable electronic device, sometimes also called subclinical AF, and lasting for at least 6 min in the absence of clinically diagnosed AF. Clinical evidence has shown that short episodes of rapid atrial tachycarrhythmias are often detected in patients presenting with stroke and transient ischaemic attack. Patients with AHRE have a higher likelihood of suffering from subsequent strokes, but their stroke rate seems lower than in patients with diagnosed AF, and not all AHRE episodes correspond to AF. The prognostic and pathological significance of AHRE is not yet fully understood. Clinical trials of OAC therapy are being conducted to determine whether therapeutic intervention would be beneficial to patients experiencing AHRE in terms of reducing the risk of stroke.
Cite This Study
Camm et al. (2016) conducted a review in Atrial high-rate episodes (AHRE). Oral anticoagulants (OACs) was evaluated on Stroke prevention. Oral anticoagulation for stroke prevention in patients with atrial high-rate episodes (AHRE) is currently being evaluated in clinical trials, as their prognostic significance remains unclear.