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KMID : 0368120210510030235
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Korean Circulation Journal
2021 Volume.51 No. 3 p.235 ~ p.247
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Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices
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Kim Min
Kim Tae-Hoon
Yu Hee-Tae
Choi Eue-Keun
Park Hyung-Seob
Park Jun-Beom
Lee Young-Soo
Kang Ki-Woon
Shim Jae-Min
Sung Jung-Hoon
Oh Il-Young
Joung Bo-Young
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Abstract
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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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KEYWORD
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Arrhythmia, Pacemaker, artificial, Sick sinus syndrome, Left atrium
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