Prevalence and Predictors of Atrial High Rate Episodes in Patients with Cardiac Implantable Electronic Devices

Abstract Background: Atrial fibrillation (AF) is the most common cardiac rhythm disorder encountered in clinical practice. It is associated with an increased risk of stroke, hospital-ization, and mortality, all of which have a significant impact on healthcare economic costs. AF is often asymptomatic and is frequently underdiag-nosed. In particular, paroxysmal episodes may be missed during clinical evaluation and electrocardiogram. Aim of Study: To investigate the prevalence and predictive factors of atrial high rate episodes in patients with cardiac implantable electronic devices and without a history of AF in order to provide a reliable basis for the clinical identification of patients with a Atrial High Rate Episodes (AHRE) in patients. Patients and Methods: This is a retrospective, observa-tional data collection study conducted at a single, tertiary care center in the Pacemaker Follow-up clinics at Ain Shams University Hospitals. Patients with dual-chamber CIED (dual-chamber pacemaker, ICD, CRT-P, and CRT-D), visiting the device clinic during the period of May 2022 to November 2022, were eligible for this data collection protocol. Results: According to the result of our study, coronary artery disease, stroke/Transient ischemic attacks, left atrial volume index >34.73 ml/m^2, left ventricular ejection fraction 48%, atrial pacing percentage >53%, and ventricular pacing percentage >97% are independent factors associated with AHREs in patients with CIEDs and without a history of AF. The clinical outcomes were not evaluated due to the small number of included patients and the short duration of the study. Conclusion: Coronary artery disease, stroke/Transient ischemic attacks, left atrial volume index >34.73 ml/m^2, left ventricular ejection fraction 48%, atrial pacing percentage >53%, and ventricular pacing percentage >97% are independ-ent factors associated with AHREs in patients with cardiac implantable electronic devices and without a history of AF.