@article{355ed55acd1c499aaf86e3828f4524bd,
title = "The influence of atrial high-rate episodes on stroke and cardiovascular death: an update",
abstract = "Atrial high-rate episodes (AHRE) are atrial tachyarrhythmias detected by continuous rhythm monitoring by pacemakers, defibrillators, or implantable cardiac monitors. Atrial high-rate episodes occur in 10-30% of elderly patients without atrial fibrillation. However, it remains unclear whether the presence of these arrhythmias has therapeutic consequences. The presence of AHRE increases the risk of stroke compared with patients without AHRE. Oral anticoagulation would have the potential to reduce the risk of stroke in patients with AHRE but is also associated with a rate of major bleeding of ∼2%/year. The stroke rate in patients with AHRE appears to be lower than the stroke rate in patients with atrial fibrillation. Wearables like smart-watches will increase the absolute number of patients in whom atrial arrhythmias are detected. It remains unclear whether anticoagulation is effective and, equally important, safe in patients with AHRE. Two randomized clinical trials, NOAH-AFNET6 and ARTESiA, are expected to report soon. They will provide much-needed information on the efficacy and safety of oral anticoagulation in patients with AHRE.",
keywords = "Anticoagulation, Atrial fibrillation, Atrial high-rate episodes, Continuous monitoring, Implantable cardiac monitor, Pacemaker, Stroke, Sub-clinical atrial fibrillation, Thrombo-embolic risk",
author = "Tobias Toennis and Emanuele Bertaglia and Axel Brandes and Wolfgang Dichtl and Nina Fluschnik and {de Groot}, {Joris R.} and Eloi Marijon and Lluis Mont and Lundqvist, {Carina Blomstr{\"o}m} and Nuno Cabanelas and Dan, {G. Andrei} and Andrzej Lubinski and Merkely, {B. la} and Kim Rajappan and Andrea Sarkozy and Vasil Velchev and Dan Wichterle and Paulus Kirchhof",
note = "Funding Information: Conflict of interest: T.T. received speaker fees from Medtronic and hon - oraria from Boston Scientific. A.B. received honorarium from Boehringer-Ingelheim, Bristol-Myers Squibb and received research grants from Theravance, Zealand Region, Canadian Institutes of Health Research and the Danish Heart Foundation. N.F. received a grant from Biotronik, speaker fees from Abbott, Medtronic, all outside the submitted work. J.R.G. receives consultant or speaker fees from Atricure, Daiichi Sakyo, Bayer, and Novartis. He received research funding through institution from Abbott, Boston Scientific, Medtronic, Atricure, and Owner RhythmCare. E.M. receives consultant fees from Abbott, Bayer, Boston Scientific, Medtronic, and Zoll Carina Blomstr{\"o}m Lundqvist received honorarium from Medtronic, Boston Scientific, Abbott, Bayer, Sanofi, Organon, Milestone, Philips, Cathprint outside this work. G.-A.D. receives speaker and consultation fees from Boehringer Ingelheim, Bayer, Novartis, Berlin Chemie, Amgen, Sanofi; nothing linked to the submitted work. B.M. received speaker fees from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Novartis. Paulus Kirchhof receives research support for basic, translational, and clinical research projects from European Union, British Heart Foundation, Leducq Foundation, Medical Research Council (UK), and German Centre for Cardiovascular Research, from several drug and de - vice companies active in atrial fibrillation and has received honoraria from several such companies in the past, but not in the last 3 years (unrelated to the submitted work). P.K. is listed as inventor on two patents held by University of Birmingham (Atrial Fibrillation Therapy WO 2015140571, Markers for Atrial Fibrillation WO 2016012783). All remaining authors have declared no conflicts of interest. Publisher Copyright: {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.",
year = "2023",
month = jul,
day = "1",
doi = "https://doi.org/10.1093/europace/euad166",
language = "English",
volume = "25",
journal = "EP Europace",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "7",
}