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Erschienen in: Cardiovascular Drugs and Therapy 5/2022

05.06.2021 | Review Article

Atrial High-Rate Episodes in Patients with Devices Without a History of Atrial Fibrillation: a Systematic Review and Meta-analysis

verfasst von: Ioannis Doundoulakis, Maria Gavriilaki, Dimitris Tsiachris, Petros Arsenos, Christos-Konstantinos Antoniou, Smaro Dimou, Stergios Soulaidopoulos, Ioannis Farmakis, Evangelos Akrivos, Panagiotis Stoiloudis, Konstantinos Notas, Vasilios K. Kimiskidis, George Giannakoulas, Stylianos Paraskevaidis, Konstantinos A. Gatzoulis, Konstantinos Tsioufis

Erschienen in: Cardiovascular Drugs and Therapy | Ausgabe 5/2022

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Abstract

Purpose

Atrial high-rate episodes (AHREs) recorded with cardiac implantable electronic devices (CIEDs) have been associated with the development of clinical atrial fibrillation (AF) and increase in stroke and death risk. We sought to perform a systematic review with a meta-analysis to evaluate the prevalence of AHREs detected by CIEDs, their association with stroke risk, development of clinical AF, and mortality among patients without a documented history of AF.

Methods

We searched several databases, ClinicalTrials.gov, references of reviews, and meeting abstract books without any language restrictions up to 9 September 2020. We studied patients with CIEDs in whom AHREs were detected. Exclusion criterion was AF history. Our primary outcome was the risk of ischemic stroke in patients with AHREs.

Results

We deemed eligible eight studies for the meta-analysis enrolling a total of 4322 patients with CIED and without a documented AF history. The overall AHRE incidence ratio was estimated to be 17.56 (95% CI, 8.61 to 35.79) cases per 100 person-years. Evidence of moderate certainty suggests that patients with documented AHREs were 4.45 times (95% CI 2.87–6.91) more likely to develop clinical AF. Evidence of low confidence suggests that AHREs were associated with a 1.90-fold increased stroke risk (95% CI 1.19–3.05). AHREs were not associated with a statistically significant increased mortality risk.

Conclusion

The present systematic review and meta-analysis demonstrated that among patients without a documented history of AF, the detection of AHREs by CIEDs was associated with significant increased risk of clinical AF and stroke.

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Metadaten
Titel
Atrial High-Rate Episodes in Patients with Devices Without a History of Atrial Fibrillation: a Systematic Review and Meta-analysis
verfasst von
Ioannis Doundoulakis
Maria Gavriilaki
Dimitris Tsiachris
Petros Arsenos
Christos-Konstantinos Antoniou
Smaro Dimou
Stergios Soulaidopoulos
Ioannis Farmakis
Evangelos Akrivos
Panagiotis Stoiloudis
Konstantinos Notas
Vasilios K. Kimiskidis
George Giannakoulas
Stylianos Paraskevaidis
Konstantinos A. Gatzoulis
Konstantinos Tsioufis
Publikationsdatum
05.06.2021
Verlag
Springer US
Erschienen in
Cardiovascular Drugs and Therapy / Ausgabe 5/2022
Print ISSN: 0920-3206
Elektronische ISSN: 1573-7241
DOI
https://doi.org/10.1007/s10557-021-07209-8

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