Shinya Yamada1, Chin-Yu Lin1, Shih-Lin Chang2, Tze-Fan Chao1, Yenn-Jiang Lin1, Li-Wei Lo1, Fa-Po Chung1, Yu-Feng Hu1, Ta-Chuan Tuan1, Jo-Nan Liao1, Abigail Louise D Te1, Yao-Ting Chang1, Ting-Yung Chang1, Cheng-I Wu1, Satoshi Higa1, Shih-Ann Chen1. 1. From the Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (S.Y., C.-Y.L., S.-L.C., T.-F.C., Y.-J.L., L.-W.L., F.-P.C., Y.-F.H., T.-C.T., J.-N.L., A.L.D.T., Y.-T.C., T.-Y.C., C.-I.W., S.-A.C.); Department of Cardiovascular Medicine, Fukushima Medical University, Japan (S.Y.); Institution of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan (S.-L.C., T.-F.C., Y.-J.L., L.-W.L., F.-P.C., Y.-F.H., T.-C.T., J.-N.L., S.-A.C.); Department of Medicine, Taipei Veterans General Hospital, Yuan-Shan Branch, Yilan, Taiwan (C.-Y.L.); and Cardiac Electrophysiology and Pacing Laboratory, Division of Cardiovascular Medicine, Makiminato Central Hospital, Okinawa, Japan (S.H.). 2. From the Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (S.Y., C.-Y.L., S.-L.C., T.-F.C., Y.-J.L., L.-W.L., F.-P.C., Y.-F.H., T.-C.T., J.-N.L., A.L.D.T., Y.-T.C., T.-Y.C., C.-I.W., S.-A.C.); Department of Cardiovascular Medicine, Fukushima Medical University, Japan (S.Y.); Institution of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan (S.-L.C., T.-F.C., Y.-J.L., L.-W.L., F.-P.C., Y.-F.H., T.-C.T., J.-N.L., S.-A.C.); Department of Medicine, Taipei Veterans General Hospital, Yuan-Shan Branch, Yilan, Taiwan (C.-Y.L.); and Cardiac Electrophysiology and Pacing Laboratory, Division of Cardiovascular Medicine, Makiminato Central Hospital, Okinawa, Japan (S.H.). slchang4@vghtpe.gov.tw.
Abstract
BACKGROUND AND PURPOSE: The risk of stroke in patients with short-run atrial tachyarrhythmia (AT) remains unclear. This study aimed to investigate the relationship between short-run AT and the stroke and the use of the CHA2DS2-VASc score for the risk stratification. METHODS: From the registry of 24-hour Holter monitoring, 5342 subjects without known atrial fibrillation or stroke were enrolled. Short-run AT was defined as episodes of supraventricular ectopic beats <5 seconds. RESULTS: There were 1595 subjects (29.8%) with short-run AT. During the median follow-up period of 9.0 years, 494 subjects developed new-onset stroke. Patients with short-run AT had significantly higher stroke rates compared with patients without short-run AT (11.4% versus 8.3%; P<0.001). In patients with short-run AT, the number of strokes per 100 person-years for patients with CHA2DS2-VASc score of 0 and 1 were 0.23 and 0.67, respectively. However, the number of them for patients with CHA2DS2-VASc score of 2, 3, 4, and ≥5 were 1.62, 1.89, 1.30, and 2.91, respectively. In patients with CHA2DS2-VASc score of 0 or 1, age (>61 years old) and burden of premature atrial contractions (>25 beats/d) independently predicted the risk of stroke. In subgroup analyses, short-run AT patients were divided into 3 groups based on their CHA2DS2-VASc scores: low score (score of 0 [men] or 1 [women]; n=324), intermediate score (score of 1 [men] or 2 [women]; n=275), and high score (score of ≥2 [men] or ≥3 [women]; n=996). When compared with low score, intermediate and high scores were independent predictors for stroke (hazard ratio, 6.165; P<0.001 and hazard ratio, 8.577; P<0.001, respectively). CONCLUSIONS: Short-run AT increases the risk of stroke. Therefore, the CHA2DS2-VASc score could be used for the risk stratification. Age and burden of premature atrial contractions were independent predictors for stroke in patients with CHA2DS2-VASc score of 0 or 1.
BACKGROUND AND PURPOSE: The risk of stroke in patients with short-run atrial tachyarrhythmia (AT) remains unclear. This study aimed to investigate the relationship between short-run AT and the stroke and the use of the CHA2DS2-VASc score for the risk stratification. METHODS: From the registry of 24-hour Holter monitoring, 5342 subjects without known atrial fibrillation or stroke were enrolled. Short-run AT was defined as episodes of supraventricular ectopic beats <5 seconds. RESULTS: There were 1595 subjects (29.8%) with short-run AT. During the median follow-up period of 9.0 years, 494 subjects developed new-onset stroke. Patients with short-run AT had significantly higher stroke rates compared with patients without short-run AT (11.4% versus 8.3%; P<0.001). In patients with short-run AT, the number of strokes per 100 person-years for patients with CHA2DS2-VASc score of 0 and 1 were 0.23 and 0.67, respectively. However, the number of them for patients with CHA2DS2-VASc score of 2, 3, 4, and ≥5 were 1.62, 1.89, 1.30, and 2.91, respectively. In patients with CHA2DS2-VASc score of 0 or 1, age (>61 years old) and burden of premature atrial contractions (>25 beats/d) independently predicted the risk of stroke. In subgroup analyses, short-run AT patients were divided into 3 groups based on their CHA2DS2-VASc scores: low score (score of 0 [men] or 1 [women]; n=324), intermediate score (score of 1 [men] or 2 [women]; n=275), and high score (score of ≥2 [men] or ≥3 [women]; n=996). When compared with low score, intermediate and high scores were independent predictors for stroke (hazard ratio, 6.165; P<0.001 and hazard ratio, 8.577; P<0.001, respectively). CONCLUSIONS: Short-run AT increases the risk of stroke. Therefore, the CHA2DS2-VASc score could be used for the risk stratification. Age and burden of premature atrial contractions were independent predictors for stroke in patients with CHA2DS2-VASc score of 0 or 1.
Authors: Bjørn Strøier Larsen; Mark Aplin; Olav Wendelboe Nielsen; Maria Helena Dominguez Vall-Lamora; Nis Baun Høst; Ole Peter Kristiansen; Hanne Kruuse Rasmusen; Ulla Davidsen; Finn Michael Karlsen; Søren Højberg; Ahmad Sajadieh Journal: Heart Rhythm O2 Date: 2021-04-22