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Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices
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 year...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Korean Society of Cardiology
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925969/ https://www.ncbi.nlm.nih.gov/pubmed/33655723 http://dx.doi.org/10.4070/kcj.2020.0393 |
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author | 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 |
author_facet | 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 |
author_sort | Kim, Min |
collection | PubMed |
description | 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. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03303872 |
format | Online Article Text |
id | pubmed-7925969 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The Korean Society of Cardiology |
record_format | MEDLINE/PubMed |
spelling | pubmed-79259692021-03-10 Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices 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 Korean Circ J Original Research 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. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03303872 The Korean Society of Cardiology 2020-12-16 /pmc/articles/PMC7925969/ /pubmed/33655723 http://dx.doi.org/10.4070/kcj.2020.0393 Text en Copyright © 2021. The Korean Society of Cardiology https://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Research 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 Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices |
title | Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices |
title_full | Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices |
title_fullStr | Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices |
title_full_unstemmed | Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices |
title_short | Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices |
title_sort | prevalence and predictors of clinically relevant atrial high-rate episodes in patients with cardiac implantable electronic devices |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925969/ https://www.ncbi.nlm.nih.gov/pubmed/33655723 http://dx.doi.org/10.4070/kcj.2020.0393 |
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