Asymptomatic Atrial Fibrillation in Pacemaker Recipients: Incidence, Progression, and Determinants Based on the Atrial High Rate Trial

Orlov, Michael V.; Ghali, Jalal K.; Araghi‒Niknam, Mohsen; Sherfesee, Lou; Sahr, Diane; Hettrick, Douglas A.

doi:10.1111/j.1540-8159.2007.00682.x

Cited by 102 publications

(59 citation statements)

References 28 publications

(54 reference statements)

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“…[1][2][3][4][5][6] However, the characteristics of AF retrieved from pacemaker interrogation, in particular its duration, may differ from those derived from clinical observations. Recent advancement of pacemaker algorithms for the prevention of atrial tachycardias, fibrillation and flutter (AT/AF) with atrial overdrive pacing (AOP) has been expected to reduce the incidence of AT/AF, though the effectiveness of these preventive algorithms is still controversial.…”

mentioning

confidence: 99%

Reliability and Characteristics of Atrial Tachyarrhythmias Detection in Dual Chamber Pacemakers

Kohno

Abe

Oginosawa

et al. 2011

Circ J

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Background: Although atrial high rate episodes (AHRE) have been commonly used to detect atrial tachyarrhythmias (AT/AF) in pacemaker patients, its reliability and characteristics are unclear. Methods and Results:39 patients with implanted dual chamber pacemakers (mean age 79.7±6.6 years), who had no history of AT/AF and were programmed in the setting of AHRE at >190 beats/min in DDD mode, were studied. An atrial overdrive pacing (AOP) algorithm was randomly programmed "ON" in 19 and "OFF" in 20 patients. AHRE were detected in 20 patients (51%), consisting of AT/AF in 15 and repetitive non-reentrant ventriculoatrial synchrony (RNRVAS) in 8 patients, all included in the AOP "ON" group. A total of 257 of 1,528 episodes of AHRE were available for analysis, including 181 and 76 episodes in the AOP "ON" and "OFF" groups, respectively. Among 181 episodes in the AOP "ON" group, 72 (40%) were RNRVAS, whereas all episodes in the AOP "OFF" group (100%) were AT/AF. Detection of RNRVAS was closely associated with a high cumulative % atrial pacing. The specificity of AT/AF detection by AHRE was 40% when the AOP algorithm was activated, vs. 100% when not in use.Conclusions: AT/AF was common in pacemaker patients without a history of AT/AF. The increase in cumulative % atrial pacing and the use of an AOP algorithm might be closely associated with RNRVAS, non-AT/AF, detected by AHRE. (Circ J 2011; 75: 1090 - 1097

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mentioning

confidence: 99%

Reliability and Characteristics of Atrial Tachyarrhythmias Detection in Dual Chamber Pacemakers

Kohno

Abe

Oginosawa

et al. 2011

Circ J

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“…A multicenter study on pacemaker diagnostics also reported a high incidence of atrial arrhythmia in the pacemaker population, with atrial high rate episodes (AHRE) documented in 89% and 46% of patients with and without prior history of atrial tachyarrhythmia by 24 months of follow-up, respectively [16]. This study demonstrated that patients with prior history of atrial arrhythmia had higher arrhythmia burden and, again, most device-detected AHRE were asymptomatic.…”

Section: Pacemakers and Icds In Detecting Afmentioning

confidence: 64%

Implanted Devices and Atrial Fibrillation

Guerra¹,

Brambatti²,

Matassini³

et al. 2012

Current Issues and Recent Advances in Pacemaker Therapy

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“…По результатам регистра SAFE, симптомные эпизоды выявлялись в 6% случаев, а в исследовании A-HIRATE доля симптомных эпизодов составила всего 5,3% [7,8]. Данная особенность может быть только частично объяснена короткой длительностью пароксизма.…”

Section: Discussionunclassified

Diagnostics of Atrial Fibrillation in Patients With Implantable Cardiac Electronic Devices: Prevalence and Risk Factors

Сазонова¹,

Андреев²,

Самойленко³

et al. 2017

Russ J Cardiol

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62Российский кардиологический журнал № 12 (152) | 2017 62Цель. Оценить распространённость и выявить факторы риска возникновения фибрилляции предсердий (ФП) у пациентов с имплантируемыми сердечными устройствами (двухкамерными электрокардиостимуляторами (ЭКС), имплан-тируемыми кардиовертерами-дефибрилляторами и устройствами для сер-дечной ресинхронизирующей терапии). Материал и методы. Дизайн работы представляет собой проспективное одноцентровое исследование с последовательным включением 304 пациен-тов в возрасте от 18 лет без документированной ФП в анамнезе, имеющих показания для имплантации или смены ЭКС. Наблюдение за пациентами про-водилось в течение 12-18 мес. с периодичностью визитов 1 раз в 3 мес. При анализе информации о нарушениях ритма, хранящейся в памяти ЭКС, значи-мыми считались эпизоды высокой предсердной частоты длительностью более 6 минут в день при частоте детекции более 175-180 уд./мин. Кроме этого, у всех пациентов были оценены клинико-демографические данные, резуль-таты лабораторного и эхокардиографического обследования. Результаты. Исследование завершили 224 пациента, остальные выбыли на различных этапах наблюдения. ФП была выявлена у 57 больных (25,4%), при этом у 43 больных (75,4%) приступы протекали бессимптомно. Спустя 3 мес. после имплантации доля выявления ФП составила 14,9% (38 пациентов из 255, пришедших на первый визит). Независимыми факторами риска разви-тия ФП являлись тромбоэмболические осложнения в анамнезе (ОР 4,72; 95% ДИ 2,279-9,77; р<0,0001), увеличенный индекс объёма левого предсердия (ОР 2,07; 95% ДИ 1,075-3,975; р=0,029), а также снижение уровня гемоглобина (ОР 2,58; 95% ДИ 1,245-5,35; р=0,011). Заключение. Распространённость ФП у больных с имплантируемыми сер-дечными устройствами достаточно высока. У большинства пациентов эпизоды аритмии протекают бессимптомно. Наиболее часто ФП выявляется в течение первых 3х мес. с момента операции. Факторами риска возникновения ФП по результатам данного исследования явились: тромбоэмболические ослож-нения в анамнезе, увеличение индекса объёма левого предсердия и снижение уровня гемоглобина. Aim. To evaluate the prevalence and to search for the risk factors of atrial fibrillation (AF) development in patients with implantable cardiac electronic devices (dualchamber stimulators (ECS), implantable cardioverter-defibrillators and resynchronizers). Material and methods. The design of the study is prospective single center, with consequent inclusion of 304 patients at the age ≥18 y. o. and with no documented AF in anamnesis, with indications for implantation of replacement of ECS. Patients followup lasted for 12-18 months with 1-3 months periodicity visits. In the analysis of data on rhythm disorders, stored in ECS memory, as significant the episodes of high cardiac rate with duration more 6 minutes per day and detection rate more than 175-180 beats per minute were taken. Also, in all the patients clinical and demographic data was assessed, laboratory and echocardiography methods applied. Results. The study was completed in 224 patients, the r...

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Asymptomatic Atrial Fibrillation in Pacemaker Recipients: Incidence, Progression, and Determinants Based on the Atrial High Rate Trial

Abstract: The incidence of AT in pacemaker recipients is high. Most device-detected AHRE are asymptomatic. Prior history of AT is associated with higher arrhythmia burden. AHRE diagnostics have a high positive predictive value for identifying AT events.

Cited by 102 publications

References 28 publications

Reliability and Characteristics of Atrial Tachyarrhythmias Detection in Dual Chamber Pacemakers

Reliability and Characteristics of Atrial Tachyarrhythmias Detection in Dual Chamber Pacemakers

Implanted Devices and Atrial Fibrillation

Diagnostics of Atrial Fibrillation in Patients With Implantable Cardiac Electronic Devices: Prevalence and Risk Factors

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