Atrial High-Rate Episodes in Patients with Devices Without a History of Atrial Fibrillation: a Systematic Review and Meta-analysis
Purpose Atrial high-rate episodes (AHREs) recorded with cardiac implantable electronic devices (CIEDs) have been associated with the development of clinical atrial fibrillation (AF) and increase in stroke and death risk. We sought to perform a systematic review with a meta-analysis to evaluate the p...
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| Veröffentlicht in: | Cardiovascular drugs and therapy 2022-10, Vol.36 (5), p.951-958 |
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| creator | Doundoulakis, Ioannis Gavriilaki, Maria Tsiachris, Dimitris Arsenos, Petros Antoniou, Christos-Konstantinos Dimou, Smaro Soulaidopoulos, Stergios Farmakis, Ioannis Akrivos, Evangelos Stoiloudis, Panagiotis Notas, Konstantinos Kimiskidis, Vasilios K. Giannakoulas, George Paraskevaidis, Stylianos Gatzoulis, Konstantinos A. Tsioufis, Konstantinos |
| description | Purpose
Atrial high-rate episodes (AHREs) recorded with cardiac implantable electronic devices (CIEDs) have been associated with the development of clinical atrial fibrillation (AF) and increase in stroke and death risk. We sought to perform a systematic review with a meta-analysis to evaluate the prevalence of AHREs detected by CIEDs, their association with stroke risk, development of clinical AF, and mortality among patients without a documented history of AF.
Methods
We searched several databases, ClinicalTrials.gov, references of reviews, and meeting abstract books without any language restrictions up to 9 September 2020. We studied patients with CIEDs in whom AHREs were detected. Exclusion criterion was AF history. Our primary outcome was the risk of ischemic stroke in patients with AHREs.
Results
We deemed eligible eight studies for the meta-analysis enrolling a total of 4322 patients with CIED and without a documented AF history. The overall AHRE incidence ratio was estimated to be 17.56 (95% CI, 8.61 to 35.79) cases per 100 person-years. Evidence of moderate certainty suggests that patients with documented AHREs were 4.45 times (95% CI 2.87–6.91) more likely to develop clinical AF. Evidence of low confidence suggests that AHREs were associated with a 1.90-fold increased stroke risk (95% CI 1.19–3.05). AHREs were not associated with a statistically significant increased mortality risk.
Conclusion
The present systematic review and meta-analysis demonstrated that among patients without a documented history of AF, the detection of AHREs by CIEDs was associated with significant increased risk of clinical AF and stroke.
Registration Number (DOI)
Available in
https://doi.org/10.17605/OSF.IO/ZRF6M
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| doi_str_mv | 10.1007/s10557-021-07209-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2537637620</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2537637620</sourcerecordid><originalsourceid>FETCH-LOGICAL-c352t-e6c6bbb19ef4a1d019425b0736f90e0f493f996bdac5639364896e80a04833003</originalsourceid><addsrcrecordid>eNp9kUFLHDEUx4ModNV-gZ4CXnpJ-5LMJJPexGotWFpsS48hM_tGI7OTbV5W2auf3NgVCj0UAuHxfr8_D_6MvZHwTgLY9yShba0AJQVYBU50e2whW6uFVY3cZwtwCoRWYF6xQ6I7qJJz3YI9npYcw8Qv482tuA4F-fk6Uloi8Tjzb6FEnAvxh1hu-Ue8j0Nd_KpD2hQeqkUl5S1PI3_JuYh9jtNUvTR_qMT3LRVc1XHg11XHBx7mJf-CJYgwh2lLkY7ZwRgmwtcv_xH7eXH-4-xSXH399Pns9EoMulVFoBlM3_fS4dgEuQTpGtX2YLUZHSCMjdOjc6ZfhqE12mnTdM5gBwGaTmsAfcTe7nLXOf3eIBW_ijRgPXbGtCGvWm1NfeoZPfkHvUubXO-tlJWdbZxtVaXUjhpyIso4-nWOq5C3XoJ_rsXvavG1Fv-nFt9VSe8kqvB8g_lv9H-sJyrTj5o</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2718749752</pqid></control><display><type>article</type><title>Atrial High-Rate Episodes in Patients with Devices Without a History of Atrial Fibrillation: a Systematic Review and Meta-analysis</title><source>SpringerLink Journals - AutoHoldings</source><creator>Doundoulakis, Ioannis ; Gavriilaki, Maria ; Tsiachris, Dimitris ; Arsenos, Petros ; Antoniou, Christos-Konstantinos ; Dimou, Smaro ; Soulaidopoulos, Stergios ; Farmakis, Ioannis ; Akrivos, Evangelos ; Stoiloudis, Panagiotis ; Notas, Konstantinos ; Kimiskidis, Vasilios K. ; Giannakoulas, George ; Paraskevaidis, Stylianos ; Gatzoulis, Konstantinos A. ; Tsioufis, Konstantinos</creator><creatorcontrib>Doundoulakis, Ioannis ; Gavriilaki, Maria ; Tsiachris, Dimitris ; Arsenos, Petros ; Antoniou, Christos-Konstantinos ; Dimou, Smaro ; Soulaidopoulos, Stergios ; Farmakis, Ioannis ; Akrivos, Evangelos ; Stoiloudis, Panagiotis ; Notas, Konstantinos ; Kimiskidis, Vasilios K. ; Giannakoulas, George ; Paraskevaidis, Stylianos ; Gatzoulis, Konstantinos A. ; Tsioufis, Konstantinos</creatorcontrib><description>Purpose
Atrial high-rate episodes (AHREs) recorded with cardiac implantable electronic devices (CIEDs) have been associated with the development of clinical atrial fibrillation (AF) and increase in stroke and death risk. We sought to perform a systematic review with a meta-analysis to evaluate the prevalence of AHREs detected by CIEDs, their association with stroke risk, development of clinical AF, and mortality among patients without a documented history of AF.
Methods
We searched several databases, ClinicalTrials.gov, references of reviews, and meeting abstract books without any language restrictions up to 9 September 2020. We studied patients with CIEDs in whom AHREs were detected. Exclusion criterion was AF history. Our primary outcome was the risk of ischemic stroke in patients with AHREs.
Results
We deemed eligible eight studies for the meta-analysis enrolling a total of 4322 patients with CIED and without a documented AF history. The overall AHRE incidence ratio was estimated to be 17.56 (95% CI, 8.61 to 35.79) cases per 100 person-years. Evidence of moderate certainty suggests that patients with documented AHREs were 4.45 times (95% CI 2.87–6.91) more likely to develop clinical AF. Evidence of low confidence suggests that AHREs were associated with a 1.90-fold increased stroke risk (95% CI 1.19–3.05). AHREs were not associated with a statistically significant increased mortality risk.
Conclusion
The present systematic review and meta-analysis demonstrated that among patients without a documented history of AF, the detection of AHREs by CIEDs was associated with significant increased risk of clinical AF and stroke.
Registration Number (DOI)
Available in
https://doi.org/10.17605/OSF.IO/ZRF6M
.</description><identifier>ISSN: 0920-3206</identifier><identifier>EISSN: 1573-7241</identifier><identifier>DOI: 10.1007/s10557-021-07209-8</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Cardiac arrhythmia ; Cardiology ; Electronic devices ; Electronic equipment ; Fibrillation ; Health risks ; Ischemia ; Medicine ; Medicine & Public Health ; Meta-analysis ; Mortality ; Patients ; Review Article ; Risk ; Statistical analysis ; Stroke ; Systematic review</subject><ispartof>Cardiovascular drugs and therapy, 2022-10, Vol.36 (5), p.951-958</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2021</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-e6c6bbb19ef4a1d019425b0736f90e0f493f996bdac5639364896e80a04833003</citedby><cites>FETCH-LOGICAL-c352t-e6c6bbb19ef4a1d019425b0736f90e0f493f996bdac5639364896e80a04833003</cites><orcidid>0000-0003-2184-3296</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10557-021-07209-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10557-021-07209-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Doundoulakis, Ioannis</creatorcontrib><creatorcontrib>Gavriilaki, Maria</creatorcontrib><creatorcontrib>Tsiachris, Dimitris</creatorcontrib><creatorcontrib>Arsenos, Petros</creatorcontrib><creatorcontrib>Antoniou, Christos-Konstantinos</creatorcontrib><creatorcontrib>Dimou, Smaro</creatorcontrib><creatorcontrib>Soulaidopoulos, Stergios</creatorcontrib><creatorcontrib>Farmakis, Ioannis</creatorcontrib><creatorcontrib>Akrivos, Evangelos</creatorcontrib><creatorcontrib>Stoiloudis, Panagiotis</creatorcontrib><creatorcontrib>Notas, Konstantinos</creatorcontrib><creatorcontrib>Kimiskidis, Vasilios K.</creatorcontrib><creatorcontrib>Giannakoulas, George</creatorcontrib><creatorcontrib>Paraskevaidis, Stylianos</creatorcontrib><creatorcontrib>Gatzoulis, Konstantinos A.</creatorcontrib><creatorcontrib>Tsioufis, Konstantinos</creatorcontrib><title>Atrial High-Rate Episodes in Patients with Devices Without a History of Atrial Fibrillation: a Systematic Review and Meta-analysis</title><title>Cardiovascular drugs and therapy</title><addtitle>Cardiovasc Drugs Ther</addtitle><description>Purpose
Atrial high-rate episodes (AHREs) recorded with cardiac implantable electronic devices (CIEDs) have been associated with the development of clinical atrial fibrillation (AF) and increase in stroke and death risk. We sought to perform a systematic review with a meta-analysis to evaluate the prevalence of AHREs detected by CIEDs, their association with stroke risk, development of clinical AF, and mortality among patients without a documented history of AF.
Methods
We searched several databases, ClinicalTrials.gov, references of reviews, and meeting abstract books without any language restrictions up to 9 September 2020. We studied patients with CIEDs in whom AHREs were detected. Exclusion criterion was AF history. Our primary outcome was the risk of ischemic stroke in patients with AHREs.
Results
We deemed eligible eight studies for the meta-analysis enrolling a total of 4322 patients with CIED and without a documented AF history. The overall AHRE incidence ratio was estimated to be 17.56 (95% CI, 8.61 to 35.79) cases per 100 person-years. Evidence of moderate certainty suggests that patients with documented AHREs were 4.45 times (95% CI 2.87–6.91) more likely to develop clinical AF. Evidence of low confidence suggests that AHREs were associated with a 1.90-fold increased stroke risk (95% CI 1.19–3.05). AHREs were not associated with a statistically significant increased mortality risk.
Conclusion
The present systematic review and meta-analysis demonstrated that among patients without a documented history of AF, the detection of AHREs by CIEDs was associated with significant increased risk of clinical AF and stroke.
Registration Number (DOI)
Available in
https://doi.org/10.17605/OSF.IO/ZRF6M
.</description><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Electronic devices</subject><subject>Electronic equipment</subject><subject>Fibrillation</subject><subject>Health risks</subject><subject>Ischemia</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Patients</subject><subject>Review Article</subject><subject>Risk</subject><subject>Statistical analysis</subject><subject>Stroke</subject><subject>Systematic review</subject><issn>0920-3206</issn><issn>1573-7241</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUFLHDEUx4ModNV-gZ4CXnpJ-5LMJJPexGotWFpsS48hM_tGI7OTbV5W2auf3NgVCj0UAuHxfr8_D_6MvZHwTgLY9yShba0AJQVYBU50e2whW6uFVY3cZwtwCoRWYF6xQ6I7qJJz3YI9npYcw8Qv482tuA4F-fk6Uloi8Tjzb6FEnAvxh1hu-Ue8j0Nd_KpD2hQeqkUl5S1PI3_JuYh9jtNUvTR_qMT3LRVc1XHg11XHBx7mJf-CJYgwh2lLkY7ZwRgmwtcv_xH7eXH-4-xSXH399Pns9EoMulVFoBlM3_fS4dgEuQTpGtX2YLUZHSCMjdOjc6ZfhqE12mnTdM5gBwGaTmsAfcTe7nLXOf3eIBW_ijRgPXbGtCGvWm1NfeoZPfkHvUubXO-tlJWdbZxtVaXUjhpyIso4-nWOq5C3XoJ_rsXvavG1Fv-nFt9VSe8kqvB8g_lv9H-sJyrTj5o</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Doundoulakis, Ioannis</creator><creator>Gavriilaki, Maria</creator><creator>Tsiachris, Dimitris</creator><creator>Arsenos, Petros</creator><creator>Antoniou, Christos-Konstantinos</creator><creator>Dimou, Smaro</creator><creator>Soulaidopoulos, Stergios</creator><creator>Farmakis, Ioannis</creator><creator>Akrivos, Evangelos</creator><creator>Stoiloudis, Panagiotis</creator><creator>Notas, Konstantinos</creator><creator>Kimiskidis, Vasilios K.</creator><creator>Giannakoulas, George</creator><creator>Paraskevaidis, Stylianos</creator><creator>Gatzoulis, Konstantinos A.</creator><creator>Tsioufis, Konstantinos</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2184-3296</orcidid></search><sort><creationdate>20221001</creationdate><title>Atrial High-Rate Episodes in Patients with Devices Without a History of Atrial Fibrillation: a Systematic Review and Meta-analysis</title><author>Doundoulakis, Ioannis ; Gavriilaki, Maria ; Tsiachris, Dimitris ; Arsenos, Petros ; Antoniou, Christos-Konstantinos ; Dimou, Smaro ; Soulaidopoulos, Stergios ; Farmakis, Ioannis ; Akrivos, Evangelos ; Stoiloudis, Panagiotis ; Notas, Konstantinos ; Kimiskidis, Vasilios K. ; Giannakoulas, George ; Paraskevaidis, Stylianos ; Gatzoulis, Konstantinos A. ; Tsioufis, Konstantinos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-e6c6bbb19ef4a1d019425b0736f90e0f493f996bdac5639364896e80a04833003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Electronic devices</topic><topic>Electronic equipment</topic><topic>Fibrillation</topic><topic>Health risks</topic><topic>Ischemia</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Mortality</topic><topic>Patients</topic><topic>Review Article</topic><topic>Risk</topic><topic>Statistical analysis</topic><topic>Stroke</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Doundoulakis, Ioannis</creatorcontrib><creatorcontrib>Gavriilaki, Maria</creatorcontrib><creatorcontrib>Tsiachris, Dimitris</creatorcontrib><creatorcontrib>Arsenos, Petros</creatorcontrib><creatorcontrib>Antoniou, Christos-Konstantinos</creatorcontrib><creatorcontrib>Dimou, Smaro</creatorcontrib><creatorcontrib>Soulaidopoulos, Stergios</creatorcontrib><creatorcontrib>Farmakis, Ioannis</creatorcontrib><creatorcontrib>Akrivos, Evangelos</creatorcontrib><creatorcontrib>Stoiloudis, Panagiotis</creatorcontrib><creatorcontrib>Notas, Konstantinos</creatorcontrib><creatorcontrib>Kimiskidis, Vasilios K.</creatorcontrib><creatorcontrib>Giannakoulas, George</creatorcontrib><creatorcontrib>Paraskevaidis, Stylianos</creatorcontrib><creatorcontrib>Gatzoulis, Konstantinos A.</creatorcontrib><creatorcontrib>Tsioufis, Konstantinos</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Cardiovascular drugs and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Doundoulakis, Ioannis</au><au>Gavriilaki, Maria</au><au>Tsiachris, Dimitris</au><au>Arsenos, Petros</au><au>Antoniou, Christos-Konstantinos</au><au>Dimou, Smaro</au><au>Soulaidopoulos, Stergios</au><au>Farmakis, Ioannis</au><au>Akrivos, Evangelos</au><au>Stoiloudis, Panagiotis</au><au>Notas, Konstantinos</au><au>Kimiskidis, Vasilios K.</au><au>Giannakoulas, George</au><au>Paraskevaidis, Stylianos</au><au>Gatzoulis, Konstantinos A.</au><au>Tsioufis, Konstantinos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Atrial High-Rate Episodes in Patients with Devices Without a History of Atrial Fibrillation: a Systematic Review and Meta-analysis</atitle><jtitle>Cardiovascular drugs and therapy</jtitle><stitle>Cardiovasc Drugs Ther</stitle><date>2022-10-01</date><risdate>2022</risdate><volume>36</volume><issue>5</issue><spage>951</spage><epage>958</epage><pages>951-958</pages><issn>0920-3206</issn><eissn>1573-7241</eissn><abstract>Purpose
Atrial high-rate episodes (AHREs) recorded with cardiac implantable electronic devices (CIEDs) have been associated with the development of clinical atrial fibrillation (AF) and increase in stroke and death risk. We sought to perform a systematic review with a meta-analysis to evaluate the prevalence of AHREs detected by CIEDs, their association with stroke risk, development of clinical AF, and mortality among patients without a documented history of AF.
Methods
We searched several databases, ClinicalTrials.gov, references of reviews, and meeting abstract books without any language restrictions up to 9 September 2020. We studied patients with CIEDs in whom AHREs were detected. Exclusion criterion was AF history. Our primary outcome was the risk of ischemic stroke in patients with AHREs.
Results
We deemed eligible eight studies for the meta-analysis enrolling a total of 4322 patients with CIED and without a documented AF history. The overall AHRE incidence ratio was estimated to be 17.56 (95% CI, 8.61 to 35.79) cases per 100 person-years. Evidence of moderate certainty suggests that patients with documented AHREs were 4.45 times (95% CI 2.87–6.91) more likely to develop clinical AF. Evidence of low confidence suggests that AHREs were associated with a 1.90-fold increased stroke risk (95% CI 1.19–3.05). AHREs were not associated with a statistically significant increased mortality risk.
Conclusion
The present systematic review and meta-analysis demonstrated that among patients without a documented history of AF, the detection of AHREs by CIEDs was associated with significant increased risk of clinical AF and stroke.
Registration Number (DOI)
Available in
https://doi.org/10.17605/OSF.IO/ZRF6M
.</abstract><cop>New York</cop><pub>Springer US</pub><doi>10.1007/s10557-021-07209-8</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2184-3296</orcidid></addata></record> |
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| subjects | Cardiac arrhythmia Cardiology Electronic devices Electronic equipment Fibrillation Health risks Ischemia Medicine Medicine & Public Health Meta-analysis Mortality Patients Review Article Risk Statistical analysis Stroke Systematic review |
| title | Atrial High-Rate Episodes in Patients with Devices Without a History of Atrial Fibrillation: a Systematic Review and Meta-analysis |
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