Device-detected atrial sensing amplitudes as a marker of increased risk for new-onset and progression of atrial high-rate episodes.

BACKGROUND

Atrial high-rate episodes (AHRE) are frequent in patients with cardiac implantable electronic devices. A decrease in device-detected P-wave amplitude may be an indicator of periods of increased risk of AHRE.

OBJECTIVE

To assess the association between P-wave amplitude and AHRE incidence.

METHODS

Remote monitoring data from 2,579 patients with no history of atrial fibrillation (23% pacemakers, 77% implantable cardioverter-defibrillators [ICDs] of which 40% providing cardiac resynchronization therapy [CRT]) were used to calculate the mean P-wave amplitude during 1 month after implantation. The association with AHRE incidence according to four strata of daily burden duration (≥15 minutes, ≥6 hours, ≥24 hours, ≥7 days) was investigated by adjusting the hazard ratio with the CHA

RESULTS

The adjusted hazard ratio (HR) for 1-mV lower mean P-wave amplitude during the first month increased from 1.10 (95% confidence interval [CI], 1.05-1.15; p<0.001) to 1.18 (CI, 1.09-1.28; p<0.001) with AHRE duration strata from ≥15 minutes to ≥7 days independently of the CHA

CONCLUSION

Device-detected P-wave amplitudes lower than 2.45 mV were associated with an increased risk of AHRE onset and progression to persistent forms of AHRE independently of the patient's risk profile.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.