Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices
- Authors
- Kim, Min; Kim, Tae-Hoon; Yu, Hee Tae; Choi, Eue-Keun; Park, Hyung-Seob; Park, Junbeom; Lee, Young Soo; Kang, Ki-Woon; Shim, Jaemin; Sung, Jung-Hoon; Oh, Il-Young; Joung, Boyoung
- Issue Date
- 3월-2021
- Publisher
- KOREAN SOC CARDIOLOGY
- Keywords
- Arrhythmia; Left atrium; Pacemaker; Sick sinus syndrome; artificial
- Citation
- KOREAN CIRCULATION JOURNAL, v.51, no.3, pp.235 - 247
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- KOREAN CIRCULATION JOURNAL
- Volume
- 51
- Number
- 3
- Start Page
- 235
- End Page
- 247
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/137768
- DOI
- 10.4070/kcj.2020.0393
- ISSN
- 1738-5520
- Abstract
- Background and Objectives: Atrial high-rate episodes (AHREs) can be continuously detected by cardiovascular implantable electronic devices (CIEDs); however, the predictors of clinically relevant AHREs are unclear. Methods: This prospective multicenter study monitored 816 patients (median age 73 years, 40.4% male) without atrial fibrillation (AF) from September 2017 to July 2020. AHREs was defined as a programmed atrial detection rate >220 beats/min. The reference values of 6 minutes and 6 hours were set to analyze clinical implication of AHREs based on previously published data that the 6 minutes excluded most episodes of oversensing. Results: During a median follow-up of 18 months (interquartile interval 9-26 months), AHREs with the longest durations of >15 seconds, >6 minutes, and >6 hours and clinically documented AF by electrocardiography were noted in 246 (30.1%), 112 (13.7%), 49 (6.0%), and 24 (2.9%) patients, respectively. Among patients developing AHREs >6 minutes, 102 (91.1%) of 112 patients were identified at the 6-month visit. Patients with AHREs >6 minutes had higher proportions of sick sinus syndrome, subjects with atrial premature beat >1% on Holter monitoring, and larger left atrium (LA) size than patients with AHREs <= 6 minutes. Multivariable logistic regression analysis showed that LA diameter >41 mm (odds ratio [OR], 2.08; 95% confidence interval [95% CI], 1.25-3.45), and sick sinus syndrome (OR, 3.22; 95% CI, 1.91-5.43) were associated with AHREs >6 minutes. Conclusions: In patients with LA diameter >41 mm, and sick sinus syndrome before CIEDs implantation is associated with risk of developing AHREs >6 minutes.
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