Arq. Bras. Cardiol. 2020; 115(6): 1072-1079
Atrial High-Rate Episodes and Their Association with Cerebral Ischemic Events in Chagasic Patients
Emanoela Lima Freitas
, Elieusa e Silva Sampaio
, Márcia Maria Carneiro Oliveira
, Lucas Hollanda Oliveira, Marcos Sergio da Silva Guimarães, Jussara de Oliveira Pinheiro, Luís Pereira de Magalhães, Guisela Steffen Bonadie Albuquerque, Cristiano Macedo
, Roque Aras
This Original Article is referred by the Short Editorial "Causing Mechanisms of Embolic Strokes in Chagas Heart Disease: Autonomic Dysfunction, a Working Hypothesis".
Abstract
Background
Atrial high-rate episodes (AHREs) are associated with an increased risk of cerebral ischemic events; however, there are no studies related to the presence of AHREs and cerebral ischemic events in Chagasic patients.
Objective
To investigate the association between the presence of AHREs ≥ 6 minutes and cerebral ischemic events in Chagasic patients.
Methods
Cohort study with Chagasic patients with implantable electronic cardiac devices (IECDs), followed at the Arrhythmia Outpatient Clinic of a University Hospital, in the city of Salvador, state of Bahia, Brazil, between May 2016 and June 2017.. Patients diagnosed with atrial flutter / atrial fibrillation, with unicameral IECD and using oral anticoagulation were excluded. AHREs with atrial frequency ≥ 190 beats per minute and duration ≥ 6 minutes (min) were considered, and cerebral ischemic events were identified by computed tomography (CT) of the skull.
Results
The 67 research participants (67.2% females, mean age 63.6 ± 9.2 years) were followed for 98 ± 28.8 days and 11.9% of the patients had AHREs ≥ 6 min. Skull CT showed silent cerebral ischemic events in 16.4% of the patients, 63.6% of whom had AHREs ≥ 6 min in the analysis of IECDs. Advanced age [OR 1.12 (95% CI 1.03-1.21; p=0.009] and the presence of AHREs ≥ 6 minutes [OR 96.2 (95% CI 9.4-987.4; p <0.001)] were independent predictors for ischemic events.
Conclusion
AHREs detected by IECDs were associated with the presence of silent cerebral ischemic events in Chagasic patients. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)
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