Why the study?
AF is often asymptomatic and underdiagnosed, with paroxysmal episodes frequently missed during routine clinical evaluation and ECG.
What are the prevalence and predictors of atrial high rate episodes in patients with cardiac implantable electronic devices and without a history of atrial fibrillation?
What are the prevalence and predictors of atrial high rate episodes in patients with cardiac implantable electronic devices and without a history of atrial fibrillation?
In patients with CIEDs and no history of AF, factors such as CAD, prior stroke/TIA, increased left atrial volume, and high pacing burden independently predict the occurrence of atrial high rate episodes.
These predictors may inform risk stratification for AHRE monitoring in CIED patients; leaves open need for prospective validation and intervention trials.
Background: Atrial fibrillation (AF) is the most common cardiac rhythm disorder encountered in clinical practice. It is associated with an increased risk of stroke, hospital-ization, and mortality, all of which have a significant impact on healthcare economic costs. AF is often asymptomatic and is frequently underdiag-nosed. In particular, paroxysmal episodes may be missed during clinical evaluation and electrocardiogram. Aim of Study: To investigate the prevalence and predictive factors of atrial high rate episodes in patients with cardiac implantable electronic devices and without a history of AF in order to provide a reliable basis for the clinical identification of patients with a Atrial High Rate Episodes (AHRE) in patients. Patients and Methods: This is a retrospective, observa-tional data collection study conducted at a single, tertiary care center in the Pacemaker Follow-up clinics at Ain Shams University Hospitals. Patients with dual-chamber CIED (dual-chamber pacemaker, ICD, CRT-P, and CRT-D), visiting the device clinic during the period of May 2022 to November 2022, were eligible for this data collection protocol. Results: According to the result of our study, coronary artery disease, stroke/Transient ischemic attacks, left atrial volume index >34.73 ml/m^2, left ventricular ejection fraction 48%, atrial pacing percentage >53%, and ventricular pacing percentage >97% are independent factors associated with AHREs in patients with CIEDs and without a history of AF. The clinical outcomes were not evaluated due to the small number of included patients and the short duration of the study. Conclusion: Coronary artery disease, stroke/Transient ischemic attacks, left atrial volume index >34.73 ml/m^2, left ventricular ejection fraction 48%, atrial pacing percentage >53%, and ventricular pacing percentage >97% are independ-ent factors associated with AHREs in patients with cardiac implantable electronic devices and without a history of AF.
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M.D. AMIRA M. AL-AWADY RIZK TAREK A. ABDEL FATTAH (2023) studied this question.
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