The Impact of the Right Heart Cavities Echocardiographic Features on Atrial-High Rate Episodes

Objectives Atrial high-rate episodes (AHRE) defined as atrial tachy-arrhythmias, detected through continuous monitoring with a cardiac implantable electronic device (CIED). AHRE's have been associated with increased risks of developing clinically manifested atrial fibrillation (AF), thromboembolism, cardiovascular events, and mortality. Several variables have been researched and identified to predict AHRE existence. The present study evaluated the association between right-heart structural and functional echocardiographic parameters and AHRE in patients with CIEDs. Materials and Methods This prospective design study included 194 patients with CIED's. The study population was divided into two groups according to presence of AHRE and analyzed the echocardiographic variables which may able to be a predictor of AHRE. Results Patients was divided into two groups: patients with AHRE (+) and without AHRE (-). The distribution of patients’ characteristics according to presence of AHRE was analyzed. The multivariate analysis revealed Age, LAVI, E/Em tricuspid (HR: 1,106, 1,015 − 1,205%95 CI, p = 0,022) and RAVI (HR: 1,035, 1,003 − 1,069 95% CI; p = 0,033) as independent predictors of AHREs. ROC curve analysis indicated that an E/Em tricuspid (AUC: 0,611, 95% CI: 0,538-0,680 p: 0.009) and RAVI (AUC = AUC: 0,707, 95% CI 0,637-0,770 p < 0.001) predicted AHREs with a cut-off value of 6.28 and a sensitivity of 53,2% and specificity of 66,7% and a cut-off value of 29,5 mL/m 2 with a sensitivity of 72,7% and a specificity of 65,9%, respectively. Conclusion The main finding of this study was "RAVI" and "E/Emtricuspid ratio" is associated with AHRE. Additionally, "RAVI" and "E/Emtricuspid ratio" is an independent predictor of AHRE existence.