Characteristics of patients with atrial high rate episodes detected by implanted defibrillator and resynchronisation devices

Abstract Aims Atrial high rate episodes (AHRE) are associated with increased risks of thromboembolism and cardiovascular mortality. However, the clinical characteristics of patients developing AHRE of various durations are not well studied. Methods This was an ancillary analysis of the multicenter, randomized IMPACT trial. In the present analysis, we classified patients according to duration of AHRE ≤6 minutes, >6 minutes to ≤6 hours, >6 hours to ≤24 hours and >24 hours, and investigated the association between clinical factors and the development of each duration of AHRE. Results Of 2,718 patients included in the trial, 945 (34.8%) developed AHRE. The incidence rates of each AHRE duration category were 10.7, 24.0, 0.14, and 0.07%, respectively. Using Cox regression analysis, heart failure was inversely associated with AHRE <6 minutes (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.40–0.85, p=0.005), while age ≥65 years and history of atrial fibrillation (AF) and/or atrial flutter (AFL) were risk factors for AHRE >6 minutes. Female gender was inversely associated with AHRE >6 minutes to ≤6 hours (HR 0.72, 95% CI 0.54–0.96, p=0.027) and >6 hours to ≤24 hours (HR 0.70, 95% CI 0.49–1.02, p=0.061). Hypertension was associated with AHRE >24 hours (HR 2.13, 95% CI 1.24–3.65, p=0.006). Conclusion AHRE >6 minutes to ≤6 hours were most prevalent among all AHRE duration categories. Age and history of AF/AFL were risk factors for AHRE >6 minutes. Women were at lower risk for AHRE >6 minutes to ≤24 hours, while hypertension was associated with AHRE >24 hours. Funding Acknowledgement Type of funding sources: None. Cumulative incidence of each AHRE burden