Incidence of atrial high rate episodes after dual-chamber permanent pacemaker implantation and its clinical predictors

Atrial high rate episodes (AHRE) confers increased morbidity and mortality amongst patients with permanent pacemaker implantation (PPI). The incidence of AHREs and it's clinical predictors in Indian patients without prior history of atrial fibrillation (AF) are not well understood. A total of 100 dual-chamber PPI patients, who had no prior history of AF, underwent pacemaker interrogation starting from a minimum of 1 month after implantation to detect any AHREs. The incidence of AHREs was 17% at a mean follow up 15.2 ± 7.5 months. Only right ventricular apical lead position was found to have an independent association with AHREs (OR: 3.50, 95% CI: 1.02-12.03; p = 0.04).

Stroke Risk in Patients with Implanted Cardiac Devices

Atrial fibrillation (AF) is associated with embolic stroke. AF can be asymptomatic and the first detection of AF may be from the stored electrograms of cardiac implantable electronic devices. These devices can digitally record and store intracardiac electrograms that satisfy criteria for AF. Current guidelines do not address management of device-detected AF and, in particular, whether these episodes should prompt the initiation of anticoagulation/antiplatelet therapy. This article reviews the data regarding management of device-detected AF.