The influence of atrial high-rate episodes on stroke and cardiovascular death: an update

  • Tobias Tönnis
  • Emanuele Bertaglia
  • Axel Brandes
  • Wolfgang Dichtl
  • Nina Becher
  • Joris R de Groot
  • Eloi Marijon
  • Lluís Mont
  • Carina Blomström-Lundqvist
  • Nuno Cabanelas
  • G. Andrei Dan
  • Andrzej Lubinski
  • Béla Merkely
  • Kim Rajappan
  • Andrea Sarkozy
  • Vasil Velchev
  • Dan Wichterle
  • Paulus Kirchhof

Beteiligte Einrichtungen

Abstract

Atrial high-rate episodes (AHRE) are atrial tachyarrhythmias detected by continuous rhythm monitoring by pacemakers, defibrillators, or implantable cardiac monitors. Atrial high-rate episodes occur in 10-30% of elderly patients without atrial fibrillation. However, it remains unclear whether the presence of these arrhythmias has therapeutic consequences. The presence of AHRE increases the risk of stroke compared with patients without AHRE. Oral anticoagulation would have the potential to reduce the risk of stroke in patients with AHRE but is also associated with a rate of major bleeding of ∼2%/year. The stroke rate in patients with AHRE appears to be lower than the stroke rate in patients with atrial fibrillation. Wearables like smart-watches will increase the absolute number of patients in whom atrial arrhythmias are detected. It remains unclear whether anticoagulation is effective and, equally important, safe in patients with AHRE. Two randomized clinical trials, NOAH-AFNET6 and ARTESiA, are expected to report soon. They will provide much-needed information on the efficacy and safety of oral anticoagulation in patients with AHRE.

Bibliografische Daten

OriginalspracheEnglisch
Aufsatznummereuad166
ISSN1099-5129
DOIs
StatusVeröffentlicht - 04.07.2023