Key result
Patients with atrial high-rate episodes had significantly greater left atrial diameter (MD 2.19 mm; 95% CI 1.11-3.28; p<0.001) and left atrial volume index than those without.
Why the study?
Atrial high-rate episodes are linked to adverse cardiovascular outcomes, but the relationship between left atrial morphology and AHRE remains unclear.
Do increased left atrial diameter and left atrial volume index predict the occurrence of atrial high-rate episodes in patients with cardiac devices and no prior atrial fibrillation?
Meta-Analysis
Do increased left atrial diameter and left atrial volume index predict the occurrence of atrial high-rate episodes in patients with cardiac devices and no prior atrial fibrillation?
Mean Difference: 2.19 (95% CI 1.11–3.28)
p-value: p=< 0.001
Increased left atrial diameter and left atrial volume index are significant predictors of atrial high-rate episodes in patients with cardiac devices and no prior history of atrial fibrillation.
Larger left atrial size may aid AHRE risk stratification in device patients; leaves open independent predictive value and need for prospective validation.
Background Recent studies have shown that atrial high‐rate episodes (AHREs) are associated with adverse cardiovascular outcomes, including an increased risk of stroke, cardiovascular mortality, and future atrial fibrillation. Despite efforts to identify predictors for AHRE, the relationship between left atrial morphology and AHRE remains unclear. Methods We systematically reviewed MEDLINE and EMBASE from inception to May 2024 to assess the association between left atrial morphology, measured as left atrial diameter (mm) and left atrial volume index (LAVI, mL/m 2 ) via transthoracic echocardiography, and the occurrence of AHRE in patients without a prior history of atrial fibrillation at device implantation. Means and standard deviations of LAD and LAVI were extracted to calculate pooled mean differences using the generic inverse variance method. Results A total of 18 cohort studies were included in the meta‐analysis. The results showed that patients with AHRE had significantly higher left atrial diameter and LAVI compared to those without AHRE. The pooled mean difference for left atrial diameter was 2.19 mm (95% CI: 1.11–3.28; I 2 = 80%, p < 0.001), while for LAVI, it was 4.88 mL/m 2 (95% CI: 2.55–7.21; I 2 = 55%, p < 0.001). Conclusions Our study demonstrated that patients with AHRE had greater left atrial diameter and LAVI than those without AHRE. Further research is needed to clarify the underlying mechanism.
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Wattanachayakul et al. (2025) conducted a meta-analysis in Atrial high-rate episodes. Atrial high-rate episodes (AHRE) vs. No AHRE was evaluated on Left atrial diameter (MD 2.19 mm, 95% CI 1.11-3.28, p=< 0.001). Patients with atrial high-rate episodes had significantly greater left atrial diameter (MD 2.19 mm; 95% CI 1.11-3.28; p<0.001) and left atrial volume index than those without.
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