The performance of five models compared with atrial high rate episodes predicts new atrial fibrillation after cardiac implantable electronic devices implantation

Abstract

Aims: Several predicting models have been evaluated for new-onset atrial fibrillation (AF) in several clinical conditions, but never in patients with cardiac implantable electronic devices (CIED). We aimed to evaluate the five predicting models compared with atrial high rate episodes (AHRE) to predict new AF in patients with CIED. Methods and Results:We retrospective enrolled 470 consecutive patients with CIED and without a history of AF. The five predicting models, including CHA 2 DS 2 -VASc score, C 2 HEST score, mCHEST score, HAT 2 CH 2 score, and HAVOC score were used.The primary endpoint was new AF documented by 12-lead electrocardiography (ECG) or 30-s ECG strip. Multivariable Cox regression analysis was used to determine variables associated with independent factors of new AF. Patients' median age was 76 years and 58.7% were male. During follow-up (median 29 months), 34 new AF occurred (incidence rate 2.99/100 patient-years, 95% CI 1.67-6.20). Multivariable Cox regression analysis showed AHRE ≥6 min and 24 h, and HAT 2 CH 2 score were independent predictors for new AF. Optimal AHRE cutoff value was 9.3 min with highest Youden index (AUC, 0.806; 95% CI, 0.722-0.889; p < .001). The AF occurrence rate of AHRE ≥9.3 min was 7 times AHRE <9.3 min (p < .001).

Value of ATRIA stroke risk score in predicting atrial high‐rate episodes: A comparison of six different risk scores

“…A number of studies comparatively assessed the efficacies of the risk scoring systems, such as CHA 2 DS 2 ‐VASc, mC 2 HEST, HAT 2 CH 2 , and ATRIA scoring systems as well as R 2 ‐CHADS 2 and R 2 ‐CHA 2 DS 2 ‐VASc scoring systems established by incorporating creatinine clearance into the CHA 2 DS 2 and CHA2DS 2 ‐VASc scoring systems, in predicting thromboembolic events and stroke. One of these studies, Chen Ju‐Yi 14 et al. reported a significant correlation between mC 2 HEST score and AHRE prevalence and that HAT 2 CH 2 score was an independent predictor for new‐onset AF in patients with a CIED.…”

“…1 Several risk scoring models, including CHA scoring system was found to perform better than other scoring systems in predicting incident AF. Lastly, in a recent study, the efficacy of mC 2 HEST 14 scoring system in predicting new-onset AF in patients with a CIED has been demonstrated. In sum, given the differences between the AHRE patient populations and the scoring systems, predicting AHRE using practical scoring systems continues to be a subject worth researching.…”