Dataset Information

Inflammation and the risk of atrial high-rate episodes (AHREs) in patients with cardiac implantable electronic devices.

ABSTRACT:

Introduction

Atrial high-rate episodes (AHREs) are associated with an increased risk of developing atrial fibrillation and thromboembolism. The characteristics of 'real world' patients developing AHREs are poorly known.

Methods

We included 496 consecutive patients with cardiac implantable electronic devices (CIEDs). Primary endpoint was occurrence of AHREs, defined as >?175 bpm and lasting?>?5 min, in a median follow-up of 16.5 (IQR 3.9-38.6) months (1082.4 patient-years). We also tested the predictive value of clinical risk scores for AHREs.

Results

Mean age was 68.8?±?14.0 years, and 35.5% were women; AHREs were recorded in 173 patients [34.7%, 16.0%/year, 95% confidence interval (CI) 13.7-18.6]. Multivariable Cox regression analysis showed that age [hazard ratio (HR) 1.020, 95% CI 1.004-1.035, p?=?0.011], prior AF (HR 3.521, 95% CI 2.831-5.206, p?2 and CHA₂DS₂VASc score CONCLUSION: AHREs are common in CIEDs patients, with age, prior AF, inflammatory markers (high CRP, white cell count) being factors associated with AHREs onset. Clinical risk scores showed limited value for AHREs prediction in this cohort.

SUBMITTER: Pastori D

PROVIDER: S-EPMC6105258 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Publications

Inflammation and the risk of atrial high-rate episodes (AHREs) in patients with cardiac implantable electronic devices.

Pastori Daniele D Miyazawa Kazuo K Li Yanguang Y Shahid Farhan F Hado Hussein H Lip Gregory Y H GYH

Clinical research in cardiology : official journal of the German Cardiac Society 20180417 9

<h4>Introduction</h4>Atrial high-rate episodes (AHREs) are associated with an increased risk of developing atrial fibrillation and thromboembolism. The characteristics of 'real world' patients developing AHREs are poorly known.<h4>Methods</h4>We included 496 consecutive patients with cardiac implantable electronic devices (CIEDs). Primary endpoint was occurrence of AHREs, defined as > 175 bpm and lasting > 5 min, in a median follow-up of 16.5 (IQR 3.9-38.6) months (1082.4 patient-years). We also ...[more]

PMID: 29667016

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Project description:BackgroundAlthough atrial high-rate episode (AHRE) and atrial fibrillation (AF) cannot entirely be identical, recent studies suggest AHRE is linked to AF development and shares some characteristics with AF regarding thromboembolism. At present, there is still lack of predictive indicators for AHRE and diagnostic methods and clinical indicators for AHRE in patients without cardiac implantable electronic device (CIED). The aim of this study was thus to explore the relationship between AHRE and left atrial (LA) strain parameters with the goal of identifying high-risk populations of AHRE by LA strain characteristics.MethodsFrom February 2022 to May 2023, a total of 105 CIED patients were enrolled and divided into two groups based on whether AHRE had occurred: AHRE (-) group (n=65) and AHRE (+) group (n=40). Real-time three-dimensional echocardiography (RT-3DE) technique was used to obtain the LA time-volume curve. The collected dynamic images were analyzed on the Echopac 204 workstation to obtain the parameters of LA. The four-dimensional automatic LA quantitative analysis (4D Auto LAQ) technology was used to analyze the LA strain parameters: LA reservoir longitudinal strain (LASr), LA conduit longitudinal strain (LAScd), LA contraction longitudinal strain (LASct), LA reservoir circumferential strain (LASr-c), LA conduit circumferential strain (LAScd-c), LA contraction circumferential strain (LASct-c). Correlation analysis was carried out using Binary logistic regression analysis. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the diagnostic performance of LASct in AHRE.ResultsBody surface area (BSA) [odds ratio (OR) =8.34, 95% confidence interval (CI): 1.32-72.30, P=0.037], LASct (OR =1.20, 95% CI: 1.05-1.39, P=0.013) and LA end-systolic volume (LAESV) (OR =1.02, 95% CI: 1.00-1.04, P=0.023) were the influencing factors of AHRE. Only LASct (OR =1.18, 95% CI: 1.01-1.38, P=0.041) was found to be an independent influencing factor of AHRE. This result remained significant after adjusting for age, sex, hypertension, diabetes, and stroke history. The ROC curve showed that the cut-off for predicting AHRE was LASct =-4.125% with sensitivity of 37.5% and specificity of 87.7%.ConclusionsThis cross-sectional study found that decreased LASct (absolute value) is an independent risk factor for the AHRE and has diagnostic efficacy in certain degree for the occurrence of AHRE.

Dataset Information

Inflammation and the risk of atrial high-rate episodes (AHREs) in patients with cardiac implantable electronic devices.

Introduction

Methods

Results

Publications

Inflammation and the risk of atrial high-rate episodes (AHREs) in patients with cardiac implantable electronic devices.

Similar Datasets

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