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K Miyazawa, Y Kondo, M Nakano, K Senoo, Y Kobayashi, G Y H Lip, P3861
Atrial high rate episodes burden improves stroke risk stratification using the CHA2DS2-VASc score: implications for anticoagulating device patients with high atrial arrhythmia burden, European Heart Journal, Volume 39, Issue suppl_1, August 2018, ehy563.P3861, https://doi.org/10.1093/eurheartj/ehy563.P3861Close - Share Icon Share
Extract
Background: Atrial high rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs) is associated with an increased risk of stroke. The impact of AHRE arrhythmia burden on improving stroke risk stratification remains uncertain, especially in Asian patients.
Purpose: We aim to investigate whether adding AHRE burden improves stroke risk stratification using the CHA2DS2-VASc score.
Methods: We enrolled patients with dual chamber CIEDs attending our university hospital. Devices were interrogated for the detection of AHREs during last 6 months. AHRE burden was divided into 3 groups; no AHRE (<5min), 5min≤AHRE<24hr, and 24hr≤AHRE.
Results: Of 455 patients, AHREs lasting at least 5 min were detected in 113 patients (24.8%). There was no significant differences in mean CHA2DS2-VASc scores between no AHRE and 5min≤AHRE<24hr groups (2.8±1.3 vs. 3.2±1.3, p=0.07), and between no AHRE and 24hr≤AHRE groups (2.8±1.3 vs. 2.8±1.8, p=0.19). During mean follow-up of 19.0±2.95 months, 12 patients (2.6%) had thromboembolic events. The predictive ability of the CHA2DS2-VASc score alone (c-index: 0.826) for thromboembolic events was not significantly changed by adding AHRE burden lasting at least 5 min (c-index: 0.860, p=0.23), but was significantly improved by adding AHRE burden ≥24hr (c-index: 0.886, p=0.04).
