Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices: Dynamic Changes in Episodes and Predictors of Incident Atrial Fibrillation
Background. Atrial high rate episodes (AHRE) detected by cardiac implantable electronic devices (CIEDs) may be associated with a risk of progression towards long-lasting episodes (≥24 h) and clinical atrial fibrillation (AF). Methods. Consecutive CIED patients presenting AHRE (with confirmation of a...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-03-01
|
| Series: | Biology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-7737/11/3/443 |
| _version_ | 1797447020087083008 |
|---|---|
| author | Jacopo Francesco Imberti Niccolò Bonini Alberto Tosetti Davide Antonio Mei Luigi Gerra Vincenzo Livio Malavasi Andrea Mazza Gregory Y. H. Lip Giuseppe Boriani |
| author_facet | Jacopo Francesco Imberti Niccolò Bonini Alberto Tosetti Davide Antonio Mei Luigi Gerra Vincenzo Livio Malavasi Andrea Mazza Gregory Y. H. Lip Giuseppe Boriani |
| author_sort | Jacopo Francesco Imberti |
| collection | DOAJ |
| description | Background. Atrial high rate episodes (AHRE) detected by cardiac implantable electronic devices (CIEDs) may be associated with a risk of progression towards long-lasting episodes (≥24 h) and clinical atrial fibrillation (AF). Methods. Consecutive CIED patients presenting AHRE (with confirmation of an arrhythmia lasting 5 min–23 h 59 min, atrial rate ≥175/min, with no AF at 12-lead ECG and no prior clinical AF) were retrospectively enrolled. The aims of this study were to describe patients’ characteristics and the incidence of adverse events, and second, to identify potential predictors of the composite outcome of clinical AF and/or AHRE episodes lasting ≥24 h. Results. 104/107 (97.2%) patients (median age 79.7 (74.0–84.2), 33.7% female) had available follow-up data. Over a median follow-up of 24.3 (10.6–40.3) months, 31/104 (29.8%) patients experienced the composite outcome of clinical AF or AHRE episodes lasting ≥24 h. Baseline CHA<sub>2</sub>DS<sub>2</sub>-VASc score and the longest AHRE episode at enrollment lasting 12 h–23 h 59 min were independently associated with the composite outcome (Hazard ratio (HR); 95% CI: 1.40; 1.07–1.83 and HR: 8.15; 95% CI 2.32–28.65, respectively). Baseline CHA<sub>2</sub>DS<sub>2</sub>-VASc score and the longest AHRE episode at enrollment lasting 12 h–23 h 59 min were the only independent predictors of incident clinical AF (HR: 1.45; 95% CI 1.06–2.00 and HR: 4.25; 95% CI 1.05–17.20, respectively). Conclusions. In patients with AHRE, the incidence of clinical AF or AHRE episodes lasting ≥24 h is high in a two-year follow-up. Baseline patients’ characteristics (CHA<sub>2</sub>DS<sub>2</sub>-VASc score) and AHRE duration may help to intensify monitoring and decision-making, being independently associated with clinical AF at follow-up. |
| first_indexed | 2024-03-09T13:49:47Z |
| format | Article |
| id | doaj.art-1de9d58eb40c45ccaa6b85accf3d9e41 |
| institution | Directory Open Access Journal |
| issn | 2079-7737 |
| language | English |
| last_indexed | 2024-03-09T13:49:47Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biology |
| spelling | doaj.art-1de9d58eb40c45ccaa6b85accf3d9e412023-11-30T20:52:17ZengMDPI AGBiology2079-77372022-03-0111344310.3390/biology11030443Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices: Dynamic Changes in Episodes and Predictors of Incident Atrial FibrillationJacopo Francesco Imberti0Niccolò Bonini1Alberto Tosetti2Davide Antonio Mei3Luigi Gerra4Vincenzo Livio Malavasi5Andrea Mazza6Gregory Y. H. Lip7Giuseppe Boriani8Department of Biomedical, Metabolic and Neural Sciences, Cardiology Division, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, Cardiology Division, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, Cardiology Division, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, Cardiology Division, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, Cardiology Division, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, Cardiology Division, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyCardiology Division, S. Maria della Stella Hospital, 05018 Orvieto, ItalyLiverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L10 0AD, UKDepartment of Biomedical, Metabolic and Neural Sciences, Cardiology Division, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyBackground. Atrial high rate episodes (AHRE) detected by cardiac implantable electronic devices (CIEDs) may be associated with a risk of progression towards long-lasting episodes (≥24 h) and clinical atrial fibrillation (AF). Methods. Consecutive CIED patients presenting AHRE (with confirmation of an arrhythmia lasting 5 min–23 h 59 min, atrial rate ≥175/min, with no AF at 12-lead ECG and no prior clinical AF) were retrospectively enrolled. The aims of this study were to describe patients’ characteristics and the incidence of adverse events, and second, to identify potential predictors of the composite outcome of clinical AF and/or AHRE episodes lasting ≥24 h. Results. 104/107 (97.2%) patients (median age 79.7 (74.0–84.2), 33.7% female) had available follow-up data. Over a median follow-up of 24.3 (10.6–40.3) months, 31/104 (29.8%) patients experienced the composite outcome of clinical AF or AHRE episodes lasting ≥24 h. Baseline CHA<sub>2</sub>DS<sub>2</sub>-VASc score and the longest AHRE episode at enrollment lasting 12 h–23 h 59 min were independently associated with the composite outcome (Hazard ratio (HR); 95% CI: 1.40; 1.07–1.83 and HR: 8.15; 95% CI 2.32–28.65, respectively). Baseline CHA<sub>2</sub>DS<sub>2</sub>-VASc score and the longest AHRE episode at enrollment lasting 12 h–23 h 59 min were the only independent predictors of incident clinical AF (HR: 1.45; 95% CI 1.06–2.00 and HR: 4.25; 95% CI 1.05–17.20, respectively). Conclusions. In patients with AHRE, the incidence of clinical AF or AHRE episodes lasting ≥24 h is high in a two-year follow-up. Baseline patients’ characteristics (CHA<sub>2</sub>DS<sub>2</sub>-VASc score) and AHRE duration may help to intensify monitoring and decision-making, being independently associated with clinical AF at follow-up.https://www.mdpi.com/2079-7737/11/3/443atrial high-rate episodesAHREatrial fibrillationsubclinical atrial fibrillationcardiac implantable electronic devicespacemaker |
| spellingShingle | Jacopo Francesco Imberti Niccolò Bonini Alberto Tosetti Davide Antonio Mei Luigi Gerra Vincenzo Livio Malavasi Andrea Mazza Gregory Y. H. Lip Giuseppe Boriani Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices: Dynamic Changes in Episodes and Predictors of Incident Atrial Fibrillation Biology atrial high-rate episodes AHRE atrial fibrillation subclinical atrial fibrillation cardiac implantable electronic devices pacemaker |
| title | Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices: Dynamic Changes in Episodes and Predictors of Incident Atrial Fibrillation |
| title_full | Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices: Dynamic Changes in Episodes and Predictors of Incident Atrial Fibrillation |
| title_fullStr | Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices: Dynamic Changes in Episodes and Predictors of Incident Atrial Fibrillation |
| title_full_unstemmed | Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices: Dynamic Changes in Episodes and Predictors of Incident Atrial Fibrillation |
| title_short | Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices: Dynamic Changes in Episodes and Predictors of Incident Atrial Fibrillation |
| title_sort | atrial high rate episodes detected by cardiac implantable electronic devices dynamic changes in episodes and predictors of incident atrial fibrillation |
| topic | atrial high-rate episodes AHRE atrial fibrillation subclinical atrial fibrillation cardiac implantable electronic devices pacemaker |
| url | https://www.mdpi.com/2079-7737/11/3/443 |
| work_keys_str_mv | AT jacopofrancescoimberti atrialhighrateepisodesdetectedbycardiacimplantableelectronicdevicesdynamicchangesinepisodesandpredictorsofincidentatrialfibrillation AT niccolobonini atrialhighrateepisodesdetectedbycardiacimplantableelectronicdevicesdynamicchangesinepisodesandpredictorsofincidentatrialfibrillation AT albertotosetti atrialhighrateepisodesdetectedbycardiacimplantableelectronicdevicesdynamicchangesinepisodesandpredictorsofincidentatrialfibrillation AT davideantoniomei atrialhighrateepisodesdetectedbycardiacimplantableelectronicdevicesdynamicchangesinepisodesandpredictorsofincidentatrialfibrillation AT luigigerra atrialhighrateepisodesdetectedbycardiacimplantableelectronicdevicesdynamicchangesinepisodesandpredictorsofincidentatrialfibrillation AT vincenzoliviomalavasi atrialhighrateepisodesdetectedbycardiacimplantableelectronicdevicesdynamicchangesinepisodesandpredictorsofincidentatrialfibrillation AT andreamazza atrialhighrateepisodesdetectedbycardiacimplantableelectronicdevicesdynamicchangesinepisodesandpredictorsofincidentatrialfibrillation AT gregoryyhlip atrialhighrateepisodesdetectedbycardiacimplantableelectronicdevicesdynamicchangesinepisodesandpredictorsofincidentatrialfibrillation AT giuseppeboriani atrialhighrateepisodesdetectedbycardiacimplantableelectronicdevicesdynamicchangesinepisodesandpredictorsofincidentatrialfibrillation |