Characteristics of patients with atrial high rate episodes detected by implanted defibrillator and resynchronization devices.

Miyazawa, Kazuo, Pastori, Daniele ORCID: 0000-0001-6357-5213, Martin, David T, Choucair, Wassim K, Halperin, Jonathan L, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and IMPACT Study Investigators, (2022) Characteristics of patients with atrial high rate episodes detected by implanted defibrillator and resynchronization devices. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 24 (3). pp. 375-383.

PDF Characteristics of patients with atrial high rate episodes detected by implanted defibrillator and resynchronization devices.pdf - Open Access published version Download (1MB) | Preview

Abstract

<h4>Aims</h4>Atrial high rate episodes (AHREs) are associated with increased risks of thromboembolism and cardiovascular mortality. However, the clinical characteristics of patients developing AHRE of various durations are not well studied.<h4>Methods and results</h4>This was an ancillary analysis of the multicentre, randomized IMPACT trial. In the present analysis, we classified patients according to the duration of AHRE ≤6 min, >6 min to ≤6 h, >6 to ≤24 h and >24 h, and investigated the association between clinical factors and the development of each duration of AHRE. Of 2718 patients included in the trial, 945 (34.8%) developed AHRE. The incidence rates of each AHRE duration category were 5.4/100, 12.0/100, 6.8/100, and 3.3/100 patient-years, respectively. The incidence rates of AHRE >6 h were significantly higher in patients at high risk of thromboembolism (CHADS2 score ≥3) compared to those at low risk (CHADS2 score 1 or 2). Using Cox regression analysis, age ≥65 years and history of atrial fibrillation (AF) and/or atrial flutter (AFL) were risk factors for AHRE >6 min. In addition, hypertension was associated with AHRE >24 h (hazard ratio 2.13, 95% confidence interval 1.24-3.65, P = 0.006).<h4>Conclusion</h4>Atrial high rate episode >6 min to ≤6 h were most prevalent among all AHRE duration categories. Longer AHREs were more common in patients at risk of thromboembolism. Age and history of AF/AFL were risk factors for AHRE >6 min. Furthermore, hypertension showed a strong impact on the development of AHRE >24 h rather than age.

Item Type:	Article
Uncontrolled Keywords:	IMPACT Study Investigators, Heart Atria, Humans, Atrial Fibrillation, Thromboembolism, Risk Factors, Defibrillators, Aged, Stroke
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	27 Sep 2023 10:32
Last Modified:	27 Sep 2023 10:32
DOI:	10.1093/europace/euab186
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3173110