Skip to main content

Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST).

Publication ,  Journal Article
Glotzer, TV; Hellkamp, AS; Zimmerman, J; Sweeney, MO; Yee, R; Marinchak, R; Cook, J; Paraschos, A; Love, J; Radoslovich, G; Lee, KL; Lamas, GA ...
Published in: Circulation
April 1, 2003

BACKGROUND: Some current pacing systems can automatically detect and record atrial tachyarrhythmias that may be asymptomatic. We prospectively studied a 312-patient (pt) subgroup of MOST (MOde Selection Trial), a 2010-patient, 6-year randomized trial of DDDR versus VVIR pacing in sinus node dysfunction (SND). The purpose of the study was to correlate atrial high rate events (AHREs) detected by pacemaker diagnostics with clinical outcomes. METHODS AND RESULTS: Pacemakers were programmed to log an AHRE when the atrial rate was >220 bpm for 10 consecutive beats. Analysis was confined to patients with at least 1 AHRE duration exceeding 5 minutes. The 312 patients were median age 74 years, 55% female, and 60% had a history of SVT. 160 of 312 (51.3%) patients enrolled had at least 1 AHRE >5 minutes duration over median follow-up of 27 months. Cox proportional hazards analysis assessed the relationship of AHREs with clinical events, adjusting for prognostic variables and baseline covariates. The presence of any AHRE was an independent predictor of the following: total mortality (hazard ratio AHRE versus no AHRE and 95% confidence intervals=2.48 [1.25, 4.91], P=0.0092); death or nonfatal stroke (2.79 [1.51, 5.15], P=0.0011); and atrial fibrillation (5.93 [2.88, 12.2], P=0.0001). There was no significant effect of pacing mode on the presence or absence of AHREs. CONCLUSIONS: AHRE detected by pacemakers in patients with SND identify patients that are more than twice as likely to die or have a stroke, and 6 times as likely to develop atrial fibrillation as similar patients without AHRE.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

April 1, 2003

Volume

107

Issue

12

Start / End Page

1614 / 1619

Location

United States

Related Subject Headings

  • Stroke
  • Middle Aged
  • Male
  • Humans
  • Heart Atria
  • Female
  • Electrocardiography, Ambulatory
  • Cardiovascular System & Hematology
  • Cardiac Pacing, Artificial
  • Atrial Fibrillation
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Glotzer, T. V., Hellkamp, A. S., Zimmerman, J., Sweeney, M. O., Yee, R., Marinchak, R., … MOST Investigators. (2003). Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST). Circulation, 107(12), 1614–1619. https://doi.org/10.1161/01.CIR.0000057981.70380.45
Glotzer, Taya V., Anne S. Hellkamp, John Zimmerman, Michael O. Sweeney, Raymond Yee, Roger Marinchak, James Cook, et al. “Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST).Circulation 107, no. 12 (April 1, 2003): 1614–19. https://doi.org/10.1161/01.CIR.0000057981.70380.45.
Glotzer TV, Hellkamp AS, Zimmerman J, Sweeney MO, Yee R, Marinchak R, et al. Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST). Circulation. 2003 Apr 1;107(12):1614–9.
Glotzer, Taya V., et al. “Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST).Circulation, vol. 107, no. 12, Apr. 2003, pp. 1614–19. Pubmed, doi:10.1161/01.CIR.0000057981.70380.45.
Glotzer TV, Hellkamp AS, Zimmerman J, Sweeney MO, Yee R, Marinchak R, Cook J, Paraschos A, Love J, Radoslovich G, Lee KL, Lamas GA, MOST Investigators. Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST). Circulation. 2003 Apr 1;107(12):1614–1619.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

April 1, 2003

Volume

107

Issue

12

Start / End Page

1614 / 1619

Location

United States

Related Subject Headings

  • Stroke
  • Middle Aged
  • Male
  • Humans
  • Heart Atria
  • Female
  • Electrocardiography, Ambulatory
  • Cardiovascular System & Hematology
  • Cardiac Pacing, Artificial
  • Atrial Fibrillation