Atrial high-rate episodes: a comprehensive review

Cardiovasc J Afr. 2021;32(2):102-107. doi: 10.5830/CVJA-2020-052. Epub 2021 Jan 15.

Abstract

Cardiac electronic implantable devices (CIEDs) have the ability to monitor, store and interpret complex arrhythmias, which has generated a new arrhythmic entity: atrial high-rate episodes (AHRE). AHRE are atrial tachyarrhythmias, detected only by CIEDs. They are widely considered a precursor to atrial fibrillation (AF) but can also be represented by other kinds of supraventricular arrhythmias such as atrial flutter or atrial tachycardia. CIED-detected AHRE are associated with an increased risk of stroke, but the risk is significantly lower than the stroke risk of clinical AF. Moreover, there seems to be no temporal correlation between AHRE and thromboembolic events. Because of the current gaps in evidence, the appropriate management of this arrythmia can be challenging. In this review we take into account the epidemiology behind AHRE, predictive factors, clinical impact and management of this arrhythmia.

Keywords: anticoagulant agents; atrial fibrillation; atrial high‐rate episodes; pacemaker; stroke.

Publication types

  • Review

MeSH terms

  • Anticoagulants
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / therapy
  • Defibrillators, Implantable
  • Heart Atria
  • Humans
  • Pacemaker, Artificial
  • Stroke*
  • Thromboembolism / epidemiology*

Substances

  • Anticoagulants