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

Autor: Doundoulakis I; First Department of Cardiology, University of Athens Medical School, Athens, Greece.; Department of Cardiology, 424 General Military Hospital, Thessaloniki, Greece., Gavriilaki M; First Department of Neurology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Tsiachris D; Athens Heart Center, Athens Medical Center, Athens, Greece., Arsenos P; First Department of Cardiology, University of Athens Medical School, Athens, Greece., Antoniou CK; First Department of Cardiology, University of Athens Medical School, Athens, Greece., Dimou S; Department of Cardiology, 424 General Military Hospital, Thessaloniki, Greece.; First Department of Cardiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Soulaidopoulos S; First Department of Cardiology, University of Athens Medical School, Athens, Greece., Farmakis I; First Department of Cardiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Akrivos E; Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki, Thessaloniki, Greece., Stoiloudis P; Second Department of Neurology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Notas K; First Department of Neurology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Kimiskidis VK; First Department of Neurology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Giannakoulas G; First Department of Cardiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Paraskevaidis S; First Department of Cardiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Gatzoulis KA; First Department of Cardiology, University of Athens Medical School, Athens, Greece., Tsioufis K; First Department of Cardiology, University of Athens Medical School, Athens, Greece.
Jazyk: angličtina
Zdroj: Cardiovascular drugs and therapy [Cardiovasc Drugs Ther] 2022 Oct; Vol. 36 (5), pp. 951-958. Date of Electronic Publication: 2021 Jun 05.
DOI: 10.1007/s10557-021-07209-8
Abstrakt: 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.
Registration Number (doi): Available in https://doi.org/10.17605/OSF.IO/ZRF6M .
(© 2021. Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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