What is the risk of clinical AF associated with atrial high rate episodes (AHREs) with a duration of greater than 5 to 6 minutes in patients implanted with a cardiocverter-defibrillator (CIED)?
In patients implanted with a CIED for conventional indications, AHREs with a duration of greater than 5 to 6 minutes have been found to be associated with a substantial risk of subsequently presenting with clinical AF (HR, 5.5-6.0). This risk was initially reported by the ancillary Atrial Diagnostics Ancillary Study of the Mode Selection Trial and then by the ASSERT study, where CIED-detected AHREs of greater than 6 minutes were followed by clinical AF detected by a surface ECG in approximately 16% of patients at 2.5 years of follow-up.