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

• Published in: Pacing and clinical electrophysiology 2023-08, Vol.46 (8), p.978-985
• Main Authors: Artac, Inanc, Karakayali, Muammer, Omar, Timor, Hamideyin, Serif, Karabag, Yavuz, Ilis, Dogan, Rencuzogullari, Ibrahim
• Format: Article
• Language: English
• Subjects: ATRIA; atrial high‐rate episodes; Cardiovascular diseases; CHA2DS2‐VASc; CIED; Population studies; Stroke; Thromboembolism
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/pace.14749

Objectives Atrial high‐rate episodes (AHRE) are asymptomatic atrial tachy‐arrhythmias detected through continuous monitoring with a cardiac implantable electronic device (CIED). AHRE's have been associated with increased risks of developing clinically manifested atrial fibrillation (AF), thromboembolism, cardiovascular events, and mortality. Several variables has been researched and identified to predict AHRE development. The aim of this study, which compared the six frequently‐used scoring systems for thromboembolic risk in AF (CHA2DS2‐VASc, mC2HEST, HAT2CH2, R2‐CHADS2, R2‐CHA2DS2‐VASc, and ATRIA) in terms of their prognostic power in predicting AHRE. Materials and methods This retrospective study included 174 patients with CIED's. The study population was divided into two groups according to presence of AHRE: patients with AHRE (+) and patients without AHRE (‐). Thereafter, patients baseline characteristics and scoring systems were analyzed for prediction of AHRE. Results The distribution of patients’ baseline characteristics and scoring systems according to presence of AHRE was evaluated. Furthermore, ROC curve analyses of the stroke risk scoring systems have been investigated in terms of predicting the development of AHREs. ATRIA, which predicted AHRE with a specificity of 92% and sensitivity of 37.5% for ATRIA values of >6, performed better than other scoring systems in predicting AHRE (AUC: 0.700, 0.626‐0.767 95% confidence interval (CI), p = .004) Conclusion AHRE is common in patients with a CIED. In this context, several risk scoring systems have been used to predict the development of AHRE in patients with a CIED. This study's findings revealed that The ATRIA stroke risk scoring system performed better than other commonly used risk scoring systems in predicting AHRE.