The Risk Factors And Thromboembolic Event Risk In Atrial High-rate Episodes Detected By Cardiac Implantable Electronic Devices

BackgroungAtrial high-rate episodes(AHRE)are well-known as subclinical atrial fibrillation,usually without clinical symptoms.In recent years,a fewer studis had found that the AHRE is common and has significant clinical implications.The clinical consequences of AHRE,which include emboli(silent or symptomatic),heart failure,and early mortality,are of paramount importance.A number of prospective studies have shown that patients with AHRE raise the risk of ischemic stroke 2-to 3-fold.In the Chinese population,AHRE patients with thromboembolic event risk is not clear.ObjectiveWe aimed to explore the risk factors and clinical outcomes in AHRE detected by cardiac implantable electronic devices.MethodsIn this study,103 patients intended to implant cardiac implantable electronic devices were enrolled and divided into two groups.All patients met all of following exclusion criteria:?any history of atrial fibrillation,atrial flutter or atrial tachycardia;?atrial fibrillation detected by electrocardiogram or Holter before operation.During a mean follow-up of 1.93 years,we compared the risk factors,thromboembolic event risk and anticoagulant therapy of the two groups.Results1.The patients with AHRE had a significantly higher scores of CHADS2 than the Non-AHRE patients(2 vs.1,P<0.01).2.Compared with AHRE group,Non-AHRE patients were older,however,the two groups had no significant statistical differences(73.3±14.4 vs.69.4±13.8,P=0.17).3.Cox proportional hazards analysis assessed the relationship of AHRE with thromboembolic events,adjusting for baseline covariates and time dependent antithrombotic therapy,the hazard ratio in the AHRE and Non-AHRE patients was 2.99(0.61 to 14.77,P=0.18).ConclusionThe CHADS2 score was higher compared with patients without AHRE.The data suggest that whether the risk of thromboembolism with AHRE was higher than that in the Non-AHRE group was not yet clear.