Medizinische Universität Graz - Research portal
Selected Publication:
Feichtenhofer, M.
Incidence of Atrial High-rate Episodes in Pacemaker- and ICD-Patients
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2021. pp. 61
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- Authors Med Uni Graz:
- Advisor:
- Scherr Daniel
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- Abstract:
- Introduction: The term atrial high-rate episode (AHRE) describes a relatively new discovered arrhythmia. Improvements in CIED technology over the past few decades made the detection of these episodes possible. Therefore, these episodes became part of a variety of clinical trials. However, due to still limited evidence, further studies are required to optimize management, risk stratification and to obtain a better understanding concerning the epidemiology, progression to clinical atrial fibrillation and adverse events (e.g., stroke, TIA, systemic embolism). Methods: This trial is designed as a prospective monocentric observational study conducted at the University Hospital Graz / Department of Internal Medicine / Division of Cardiology. 42 CIED patients have been included from 2018 to 2020. The baseline assessment was paired with retrieving data from the implanted pacemaker or ICD memory unit and a 24h-Holter-ECG installation. A follow-up assessment was performed six months after the initial evaluation, including a data collection from the CIED and anamnesis. Statistical analyses of the gathered data were performed using SPSS Statistics Version 27.0 (IBM, Armonk, NY). Results: 42 patients with CIED were included during the baseline assessment. Unfortunately, 12 of these patients had to be excluded from further analyses since these patients missed the follow-up assessment. The gathered data revealed a prevalence of atrial high-rate episodes in around 38,1% of CIED-patients during baseline assessment and in 26,7% of CIED-patients during their six-month follow-up evaluation. Two of the included patients needed a hospitalization during the six-month trial. None of the hospitalizations were due to an underlying cardiovascular cause. No patient suffered from a TIA, stroke, or other cardiovascular events. Discussion: This clinical trial confirms that AHRE is a common phenomenon in CIED-patients, while the clinical and therapeutic significance remains unknown. Furthermore, patients with high CHA2DS2VASc-Scores (> 4) have a significantly higher risk of developing atrial high-rate episodes. Additionally, 24h-Holter-ECG showed a significantly lower detection rate than CIED memory analyses regarding AHRE, suggesting implanted devices as the primary diagnostic tool.