Document Detail

Clinical significance of pacemaker-detected atrial high-rate episodes.
MedLine Citation:
PMID:  18281829     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Pacemakers currently being implanted offer several advanced diagnostic features. Among these is the ability to store counters and intracardiac electrograms of individual atrial high-rate episodes, which are a surrogate of atrial fibrillation. As the majority of these episodes are brief and asymptomatic, their clinical significance remains to be determined. The purpose of this review is to provide a better understanding of the clinical significance of pacemaker-detected atrial high-rate episodes. RECENT FINDINGS: Follow-up after dual-chamber pacemaker implantation demonstrates that nearly 30% of patients without a known history of atrial fibrillation develop an atrial high-rate episode lasting 5 min or more. Patients experiencing such an episode are at a twofold increased risk of stroke and death. An important risk factor for developing an atrial high-rate episode is a high burden of right ventricular pacing, suggesting that ventricular pacing should be minimized whenever possible. SUMMARY: Atrial high-rate episodes are frequently observed in patients after dual-chamber pacemaker implantation and can be associated with adverse outcomes. Ongoing studies seek to determine whether the overall burden of these episodes correlates with the risk of thromboembolism, especially in patients without a history of atrial fibrillation, which would help guide decision-making regarding the initiation of anticoagulation.
Anisha Mandava; Suneet Mittal
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  23     ISSN:  0268-4705     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-02-18     Completed Date:  2008-04-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  60-4     Citation Subset:  IM    
Al-Sabah Arrhythmia Institute and Division of Cardiology, The St Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York, USA.
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MeSH Terms
Atrial Fibrillation / diagnosis*
Early Diagnosis
Pacemaker, Artificial*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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