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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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Author(s)
Min KimTae-Hoon KimHee Tae YuEue-Keun ChoiHyung-Seob ParkJunbeom ParkYoung Soo LeeKi-Woon KangJaemin ShimJung-Hoon SungIl-Young OhBoyoung Joung
Keimyung Author(s)
Park, Hyoung Seob
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Circulation Journal
Issued Date
2021
Volume
51
Issue
3
Keyword
ArrhythmiaPacemaker, artificialSick sinus syndromeLeft atrium
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.
Keimyung Author(s)(Kor)
박형섭
Publisher
School of Medicine (의과대학)
Citation
Min Kim et al. (2021). Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices. Korean Circulation Journal, 51(3), 235–247. doi: 10.4070/kcj.2020.0393
Type
Article
ISSN
1738-5555
Source
https://e-kcj.org/search.php?where=aview&id=10.4070/kcj.2020.0393&code=0054KCJ&vmode=FULL
DOI
10.4070/kcj.2020.0393
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43357
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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