AI Article Synopsis
- This study investigates the connection between atrial high-rate episodes (AHREs) detected by pacemakers and the risk of ischemic stroke or systemic embolism (SE) in older Japanese patients with a mean age of 80.
- Out of 343 patients, nearly half experienced AHREs; however, only 6% suffered from stroke or SE, with a strong correlation found between AHREs and strokes/SE in those classified with a high thromboembolic risk (CHADS score >2).
- The findings suggest that AHREs are significant indicators of stroke risk in high-risk patients, but not in those with low to intermediate thromboembolic risk.
Article Abstract
Objective: The clinical significance of atrial high-rate episodes (AHREs) detected by cardiac devices among patients with implantable pacemakers has recently emerged. However, the relationship between AHREs and ischaemic stroke and systemic embolism (SE) is not well understood in the Japanese population.
Methods: This study included 343 patients with pacemakers capable of continuous atrial rhythm monitoring (167 males; mean age, 80±7 years). Atrial tachyarrhythmia detection was programmed to the nominal setting of each device, and AHRE was defined as any episode of sustained atrial tachyarrhythmia lasting for more than 6 min. Thromboembolic risk was defined based on the CHADS score.
Results: During the follow-up period (52±30 months), 165 (48%) patients had at least one episode of AHREs, and 19 (6%) patients experienced stroke/SE. Among patients who experienced stroke/SE, 14 had AHREs before the stroke/SE. AHREs were significantly associated with stroke/SE (HR 2.87; 95% CI 1.10 to 8.90; p=0.03). Subgroup analysis conducted to investigate the impact of the CHADS score severity on stroke/SE revealed that AHREs were not associated with stroke/SE in patients with low or intermediate thromboembolic risk (CHADS score 0-2; n=217). In contrast, among patients with high thromboembolic risk (CHADS score>2; n=126), there was a significant association between AHREs and the incidence of stroke/SE (HR 3.73; 95% CI 1.06 to 13.1; p=0.04).
Conclusion: AHREs detected by pacemaker were associated with ischaemic stroke/SE in the Japanese population. However, this association was observed only in the high thromboembolic risk group.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5692098 | PMC |
| http://dx.doi.org/10.1136/heartasia-2017-010954 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Treatment of very high risk membranous nephropathy complicated by pulmonary embolism with glucocorticoids and rituximab: Case report.
Medicine (Baltimore)
January 2025
Division of Nephrology, Department of Medicine, National University Hospital, Singapore.
Rationale: We report the efficacy of combination prednisolone and intravenous (IV) rituximab as an immunosuppressive regimen for a young male presenting with extensive venous thromboembolism including a submassive pulmonary embolism secondary to life-threatening nephrotic syndrome from very high risk anti-phospholipase-A2 receptor (PLA2R) positive membranous nephropathy. Initial treatment was with mechanical thrombectomy and anticoagulation. Thereafter, oral prednisolone was initiated to induce remission, during a period of uninterrupted anticoagulation.
View Article and Find Full Text PDFTreatment-Emergent Major Adverse Cardiovascular and Thromboembolic Events were Infrequent During Clinical Trials of Pegloticase.
Rheumatology (Oxford)
January 2025
Amgen Inc, Thousand Oaks, CA, USA.
Objectives: Long-term maintenance of serum urate (SU) levels <6 mg/dl reduces gout flare frequency. However, urate-lowering therapy (ULT) initiation can induce gout flare. The incidence of thromboembolic (TE) and cardiovascular (CV) events has been shown to increase in the 30 and 120 days following gout flare, respectively; therefore, the question of ULT initiation increasing patient risk for CV/TE events has been raised.
View Article and Find Full Text PDFThe role of lipoprotein(a) in atrial fibrillation: a systematic review.
Pol Arch Intern Med
January 2025
Introduction: Atrial fibrillation (AF) is the most prevalent form of cardiac arrhythmia worldwide. Early diagnosis and treatment are essential, emphasizing the need to develop novel biomarkers. Lipoprotein(a) [Lp(a)] has recently been widely investigated as a potential risk factor for various cardiovascular conditions, including AF.
View Article and Find Full Text PDFImpact of Baseline Thrombocytopenia on Early Outcomes in Patients With Acute Venous Thromboembolism.
Am J Hematol
January 2025
Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM - Universidad Católica San Antonio de Murcia, Barcelona, Spain.
Managing acute venous thromboembolism (VTE) in patients with thrombocytopenia is challenging. We used data from the RIETE registry to investigate the impact of baseline thrombocytopenia on early VTE-related outcomes, depending on the initial presentation as pulmonary embolism (PE) or isolated lower-limb deep vein thrombosis (DVT). From March 2003 to November 2022, 90 418 patients with VTE were included.
View Article and Find Full Text PDFAtrial Septal Defect Occluder-Induced Left Atrial Injury: A Paradoxical Source of Embolic Strokes.
Ann Thorac Surg Short Rep
September 2024
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
Transcatheter atrial septal defect closure is a prevalent minimally invasive treatment option but still has cerebrovascular accident (CVA) risk. An unusual thromboembolic CVA cause is device-related mechanical atrial injury. We describe the case of a patient with prior transcatheter atrial septal defect closure who had ongoing CVA despite anticoagulation.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!